Longitudinal study of bacterial, viral, and fungal infections in adult recipients of bone marrow transplants

The epidemiology of infections was studied in a retrospective cohort of 446 recipients of bone marrow transplants (BMTs; 92 of which were allogeneic a nd 354 of which were autologous) during 1993-1996. Infections that were mic robiologically documented in 274 recipients included bacteremia, urinary tr act infections, cytomegalovirus viremia, fungemia, invasive aspergillosis, and catheter-related infections. During the period of neutropenia, no diffe rences were found between recipients of allogeneic BMTs and recipients of a utologous BMTs with regard to the incidence and the nature of infection. Af ter patients underwent engraftment, bacteremia, cytomegalovirus viremia, an d invasive aspergillosis were significantly more common in recipients of al logeneic BMTs than in recipients of autologous BMTs. Deaths caused by infec tion were uncommon and were mainly the result of invasive aspergillosis. Th erefore, empirical antimicrobial therapy should be the same for recipients of both allogeneic and autologous BMTs during the period of neutropenia; af ter engraftment, more attention should be paid to the risk of infection in allogeneic BMT recipients, particularly with regard to detection and preven tion of invasive aspergillosis.