Mycobacterial infections in adult recipients of allogeneic hematopoietic stem cell transplantation: A cohort study in a high endemic area

Yao Chung Liu, Chi Jung Wu, Po Shen Ko, Sheng Hsuan Chien, Nai Wen Fan, Hao Yuan Wang, Jyh Pyng Gau, Chia Jen Liu, Liang Tsai Hsiao, Tzeon Jye Chiou, Chun Yu Liu, Jin Hwang Liu

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Background: Mycobacterial infections are important and potentially life-threatening complications after organ transplantations. Notably, for the recipients of allogeneic hematopoietic stem cell transplantation (HSCT), there are a few supporting results to explore post-transplant mycobacterial infections. Taiwan is a high endemic area of the infection. We aim to investigate the incidence, risk factors, and survival of post-transplant mycobacterial infections, including mycobacterium tuberculosis (MTB) and non-tuberculous mycobacterium (NTM). Methods: We included 422 adult patients undergoing allogeneic HSCT at an Asian tertiary medical center between January 2003 and December 2014. A total 26 subjects developed post-transplant mycobacterial infections. Risk factors, clinical features, and survival for post-transplant mycobacterial infections were collected and analyzed. Results: Post-transplant mycobacterial infections occurred in 26 (6.2%) of 422 HSCT patients. Two-year cumulative incidences in MTB and NTM were 1.4% and 5.4%. In the multivariate analysis, being age >45 years (adjusted HR 2.21, 95% CI 1.01–4.83) and extensive chronic graft-versus-host disease (cGVHD) (adjusted HR 4.95, 95% CI 2.14–11.46) were identified as independent risk factors of infections. There was a trend as a risk factors in relapsed patients (P = 0.088). For patients with cGVHD, there was a significant difference of post-transplant survival between mycobacterial infections and none (P = 0.036). Pneumonia contributed most to mortality (n = 11, 42.3%). Conclusion: Mycobacterial infections are worth to note in a high endemic area. Once a high-risk group is identified, much effort is required to target new approaches for prevention, early detection and treatment of infections.

Original languageEnglish
Pages (from-to)274-282
Number of pages9
JournalJournal of Microbiology, Immunology and Infection
Volume53
Issue number2
DOIs
Publication statusPublished - Apr 2020
Externally publishedYes

Keywords

  • Graft-versus-host disease
  • Hematopoietic stem cell transplantation
  • Mycobacterial infections
  • Mycobacterium tuberculosis
  • Non-tuberculous mycobacterium

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

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