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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
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Polymicrobial pulmonary infection in patients with hematological malignancies: prevalence, co-pathogens, course and

Emilia Hardak1,2, Irit Avivi3,4, Lina Berkun5

  • 1Division of Pulmonary Medicine, Rambam Health Care Campus, 8 Ha'Aliya Street, 31096, Haifa, Israel. e_hardak@rambam.health.gov.il.

Infection
|January 22, 2016
PubMed
Abstract

Insights

Polymicrobial pneumonia is common in hematological malignancy patients, particularly after stem cell transplants. This severe infection has a nearly 50% mortality rate, necessitating a search for multiple pathogens.

Area of Science:

  • Infectious Diseases
  • Hematology
  • Pulmonology

Background:

  • Polymicrobial pneumonia in hematological malignancies (HM) is not well understood.
  • This study investigates its prevalence, risk factors, and outcomes.

Purpose of the Study:

  • To determine the frequency and clinical significance of polymicrobial pneumonia in HM patients.
  • To identify risk factors, clinical characteristics, and outcomes.

Main Methods:

  • A 5-year study of 436 adult HM patients with pulmonary infiltrates.
  • Diagnostic fiberoptic bronchoscopy with bronchoalveolar lavage was performed.
  • Infectious etiology was diagnosed in 219 patients; 45 (20.5%) had polymicrobial pneumonia.

Main Results:

  • 45 HM patients had polymicrobial pneumonia (39 with 2 pathogens, 6 with 3).
  • Aspergillus sp. was the most common co-pathogen (87%).
  • Allogeneic hematopoietic stem cell transplantation (HSCT) and graft-versus-host disease (GVHD) predicted polymicrobial infection.
  • Polymicrobial pneumonia showed more dyspnea, hemoptysis, and respiratory support needs.
  • In-hospital mortality was significantly higher (49% vs. 19%).

Conclusions:

  • Polymicrobial pulmonary infections are frequent in HM patients, especially those with allogeneic HSCT and GVHD.
  • These infections have a severe clinical course with nearly 50% mortality.
  • Clinicians should actively seek co-pathogens in immunosuppressed HM patients with pneumonia.
Keywords:
Bronchoalveolar lavageFiberoptic bronchoscopyHematological malignanciesPolymicrobial pulmonary infection

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