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[Measures for the prevention of infections in patients with bone marrow transplantations]
L Rasero1, A Errico, A Bertelli
1Unità di Trapianto di Midollo Osseo, Divisione di Ematologia, Ospedale di Careggi, Firenze.
Abstract:
One of the most frequent complications in patients undergoing bone marrow transplantation (BMT) is represented by severe infectious episodes, neutropenia being the most important factor. Among preventive measures, those represented by careful hygenic and environmental procedures are of pivotal importance. In this study, we retrospectively analyzed the infectious episodes in 295 patients subjected to BMT who have been treated with the same caring protocol. In 21.8% of patients an infectious event was recorded during the post-BMT period; in patients subjected to BMT from an unrelated donor the incidence of positive haemocultures was as high as 33.3%. Sixty-five per cent of isolated agents in haemocultures were Gram-positive, 33% Gram-negative and only 2% fungi. In 35% of patients with positive haemocultures, the same infectious agent had previously been isolated in a skin sample. Overall, the incidence of documented infections was lower than in other studies, suggesting that careful protocols of personal and environmental hygene may be very important for the prevention of infectious episodes in BMT patients.
Insights
Strict hygiene protocols significantly reduce infectious episodes in bone marrow transplant (BMT) patients. This study highlights the importance of environmental and personal hygiene in preventing post-transplant infections, especially in high-risk cases.
Area of Science:
- Hematology
- Infectious Diseases
- Transplantation Immunology
Context:
- Bone marrow transplantation (BMT) is associated with a high risk of severe infectious complications.
- Neutropenia is a primary risk factor for these infections.
- Preventive measures, including meticulous hygiene, are crucial for patient outcomes.
Purpose:
- To retrospectively analyze the incidence and characteristics of infectious episodes in 295 BMT patients.
- To evaluate the effectiveness of a standardized caring protocol emphasizing hygiene.
- To identify common pathogens and potential sources of infection in the post-BMT period.
Summary:
- Infectious events occurred in 21.8% of BMT patients, with higher rates (33.3%) in those receiving transplants from unrelated donors.
- Gram-positive bacteria were the most common pathogens (65%) in positive blood cultures, followed by Gram-negative bacteria (33%).
- A significant proportion (35%) of infections involved agents previously isolated from skin samples, underscoring the role of endogenous flora.
Impact:
- The study suggests that rigorous personal and environmental hygiene protocols can lower the incidence of documented infections in BMT patients.
- Findings support the implementation of enhanced infection control strategies in BMT units.
- This research contributes to understanding infection prevention in immunocompromised patients undergoing transplantation.