Common Catheter-Related Microbial Infections in Bone Marrow Transplant Patients

Ahanagarpour, Akram; Alqasi, Arash; Bitaraf, Saeid; Salehi Kahyesh, Roya; Ranjbaryan, Mostafa

Common Catheter-Related Microbial Infections in Bone Marrow Transplant Patients

Document Type : Original Article

Authors

Akram Ahanagarpour ¹

Arash Alqasi ²

Saeid Bitaraf ²

Roya Salehi Kahyesh ²

Mostafa Ranjbaryan ³

¹ Professor, Department of Physiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences.

² Assistant Professor, Faculty member of Thalassemia & Hemoglobinopathy Research center, Health Research institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

³ Thalassemia & Hemoglobinopathy Research center, Health Research institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Abstract

Background and Objectives: Bone marrow transplant patients often rely on catheters for various medical procedures, including the administration of medications and blood draws. However, catheters can sometimes lead to complications and infections, significantly affecting a patient''s overall health and recovery. The purpose of this study was to investigate common catheter infections in bone marrow transplant patients at Baqai 2 Hospital of Ahvaz.
Subjects and Methods This retrospective study included all patients (children/adults) undergoing bone marrow transplants at Bagai 2 Hospital of Ahvaz from 2021 to 2022. Catheter culture results, including bacterial isolation using standard microbiological methods (culture on BA medium, nutrient agar medium, and Cetrimide agar base), were recorded on a researcher-developed checklist. The data were subsequently analyzed using SPSS software, and the rate of catheter infection, as well as other associated factors, were investigated using the chi-square statistical test.
Results A total of 138 transplant patients were included in the study, with ages spanning 4 to 69 years. The average length of hospital stay for these patients over the two years was 23.04 days. Patient diagnoses varied, with Hodgkin''s disease and multiple myeloma each accounting for 23.08% of cases. AML and neuroblastoma each represented 15.38%, while ALL, PCSNSL, and thalassemia major each made up 7.7% of the cohort. Regarding catheter cultures, there were no positive cultures in 2021. However, in 2022, the prevalence of positive cultures was 8.30% (0.002%-38.47%), which was specifically identified in a 52-year-old patient with diabetes.
Conclusion Underlying disease in bone marrow transplant patients can play an important role in catheter infections.

Keywords

Human

Bone marrow transplant

Catheters

Risk factor

Subjects

Medical

[1] Carreras E, Dufour C, Mohty M, Kröger N. The EBMT handbook: hematopoietic stem cell transplantation and cellular therapies. [10.1007/978-3-030-02278-5 ] [PMID]

[2] Murthy GS, Hari PN, Szabo A, Pasquini M, Narra R, Khan M, Abedin S, Chhabra S, Dhakal B, D''Souza A, Drobyski WR. Outcomes of reduced-intensity conditioning allogeneic hematopoietic cell transplantation performed in the inpatient versus outpatient setting. Biology of Blood and Marrow Transplantation. 2019 Apr 1;25(4):827-33. [10.1016/j.bbmt.2018.12.069 ] [PMID]

[3] Lee SJ, Astigarraga CC, Eapen M, Artz AS, Davies SM, Champlin R, Jagasia M, Kernan NA, Loberiza Jr FR, Bevans M, Soiffer RJ. Variation in supportive care practices in hematopoietic cell transplantation. Biology of Blood and Marrow Transplantation. 2008 Nov 1;14(11):1231-8. [10.1016/j.bbmt.2008.08.008 ] [PMID]

[4] Bhatia S, Francisco L, Carter A, Sun CL, Baker KS, Gurney JG, McGlave PB, Nademanee A, O''Donnell M, Ramsay NK, Robison LL. Late mortality after allogeneic hematopoietic cell transplantation and functional status of long-term survivors: report from the Bone Marrow Transplant Survivor Study. Blood, The Journal of the American Society of Hematology. 2007 Nov 15;110(10):3784-92. [10.1182/blood-2007-03-082933 ] [PMID]

[5] Bacigalupo A, Socié G, Hamladji RM, Aljurf M, Maschan A, Kyrcz-Krzemien S, Cybicka A, Sengelov H, Unal A, Beelen D, Locasciulli A. Current outcome of HLA identical sibling versus unrelated donor transplants in severe aplastic anemia: an EBMT analysis. haematologica. 2015 May;100(5):696. [10.3324/haematol.2014.115345 ] [PMID]

[6] Marr KA. Delayed opportunistic infections in hematopoietic stem cell transplantation patients: a surmountable challenge. Hematology 2010, the American Society of Hematology Education Program Book. 2012 Dec 8;2012(1):265-70. [10.1182/asheducation-2012.1.265 ] [PMID]

[7] Godara A, Siddiqui NS, Munigala S, Dhawan R, Kansagra AJ, Rapoport AP, Yared JA, Dahiya S. Length of stay and hospital costs for patients undergoing allogeneic stem-cell transplantation. JCO oncology practice. 2021 Mar;17(3):e355-68. [10.1200/OP.20.00170 ] [PMID]

[8] Afsharian M, Hamzelo L, Janbakhsh A, Mansouri F, Sayad B, Vaziri S, Azizi M, Zamanian MH, Noori M. Frequency of Infectious Agents After Bone Marrow Transplantation in Various Regions of Iran (2001-2017): A Systematic Review. Journal of Kermanshah University of Medical Sciences. 2021 Jan 1;25(25).

[9] Heidenreich D, Hansen E, Kreil S, Nolte F, Jawhar M, de Gutierrez AH, Hofmann WK, Klein SA. Influence of the insertion site on central venous catheter-related complications in patients undergoing allogeneic hematopoietic cell transplantation. Biology of Blood and Marrow Transplantation. 2020 Jun 1;26(6):1189-94. [10.1016/j.bbmt.2020.02.007 ] [PMID]

[10] Martino P, Micozzi A, Venditti M, Gentile G, Girmenia C, Raccah R, Santilli S, Alessandri N, Mandelli F. Catheter-related right-sided endocarditis in bone marrow transplant recipients. Reviews of infectious diseases. 1990 Mar 1;12(2):250-7. [10.1093/clinids/12.2.250 ] [PMID]