Aerobic bacterial and fungal infections in peripheral blood stem cell transplants

Allogeneic and autologous peripheral blood stem cell transplants are freque ntly complicated by infections. This study was performed to evaluate early and late infections in 74 patients who underwent peripheral blood stem cell transplantation (PBSCT). Fifty-eight patients received allogeneic and 16 a utologous PBSCT, All patients received fluconazole, ciprofloxacin and acycl ovir prophylaxis. 93.1% of alloPBSCT patients and 87.5% of autoPBSCT patien ts developed fever. Febrile episodes were commonly seen in the week of tran splantation (66%), There was a median of 3 days with fever in alloPBSCT, an d 2 days in autoPBSCT, Period of neutropenia was 15 days for AlloPBSCT and 12 days for AutoPBSCT, The microbiological identification rate was 47% (32/ 68), Gram-positive infections dominated the early period (50%) and Gram-neg ative bacterial infections dominated the late period (50%), All our patient s had Hickman-type catheters and 26 infections involving catheters were see n. Sixteen occurred in the early, and 10 in the late period. Ten of 14 (71. 4%) late bacterial infections were catheter-related. The dominance of Gram- positive infections and high rates of methicillin resistance warranted the use of vancomycin extensively. Surveillance cultures were found to be usefu l in selected patients, Although slime factor is an important virulence fac tor, there was no difference between slime factor positive and negative coa gulase-negative staphylococci isolated during infections. In conclusion, fe brile episodes are the most frequent complication of PBSCT and Gram-positiv e microorganisms remain the main pathogen in these patients because of cath eter use, mucositis and ciprofloxacin prophylaxis, Methicillin resistance i s increasing and glycopeptides remain the only choice for treating such inf ections. Although the infection rate is high, measures taken to prevent and treat infections result in very low rates of mortality from infection in P BSCT patients.