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Infectious gastroenteritis in bone-marrow-transplant recipients
Abstract:
We prospectively evaluated infections with several gastrointestinal pathogens in patients undergoing bone-marrow transplantation, in an attempt to correlate infection with morbidity and mortality. Thirty-one of 78 patients (40 per cent) were infected with one or more of the following enteric pathogens during the study: adenovirus (12 infections), rotavirus (nine), coxsackievirus (four), or Clostridium difficile (12). Several patients were infected with more than one pathogen. Infection correlated with the occurrence of diarrhea and abdominal cramps. The mortality rate among the infected patients was 55 per cent--significantly higher than the rate (13 per cent) among the noninfected patients (P less than 0.001). This study indicates that enteric pathogens that often cause mild diarrhea in normal populations can cause serious infections in marrow-transplant recipients. Measures aimed at preventing or treating such infections might reduce the morbidity and mortality associated with marrow transplantation.
Insights
Gastrointestinal infections from common pathogens like adenovirus and Clostridium difficile significantly increase mortality in bone-marrow transplant patients. Early detection and treatment of these infections are crucial for improving survival rates.
Area of Science:
- Infectious Diseases
- Hematology
- Transplantation Medicine
Background:
- Bone-marrow transplantation (BMT) recipients are immunocompromised, increasing susceptibility to infections.
- Gastrointestinal infections can lead to significant morbidity and mortality in this vulnerable population.
Purpose of the Study:
- To prospectively evaluate the incidence of gastrointestinal pathogen infections in BMT patients.
- To correlate these infections with patient morbidity and mortality outcomes.
Main Methods:
- Prospective evaluation of 78 patients undergoing BMT.
- Identification of enteric pathogens including adenovirus, rotavirus, coxsackievirus, and Clostridium difficile.
- Correlation of infection status with clinical outcomes such as diarrhea, abdominal cramps, and mortality.
Main Results:
- 40% of patients (31/78) acquired infections with one or more enteric pathogens.
- Adenovirus and Clostridium difficile were the most common pathogens identified.
- Infected patients experienced higher rates of diarrhea and abdominal cramps.
- Mortality rate was significantly higher in infected patients (55%) compared to non-infected patients (13%) (P < 0.001).
Conclusions:
- Enteric pathogens, typically causing mild illness, can lead to severe infections in BMT recipients.
- These infections are associated with increased morbidity and mortality post-transplantation.
- Preventive and therapeutic strategies targeting these pathogens may improve outcomes for BMT patients.