EARLY BACTERIAL INFECTIONS IN 103 PATIENTS TREATED WITH BONE MARROW TRANSPLANTATION

PURPOSE: To analyse bacterial infections in the period immediately following bone-marrow transplantation. PATIENTS AND METHODS: A retrospective study of 174 febrile episodes appearing on 103 patients treated with bone-marrow transplantation in 1990 and 1991 was carried out, special attention being paid to the bacterial infections. RESULTS: Virtually all patients (100/103) had at least one febrile episode, and its infectious character was documented in 54% of the instances. Gram-positive germs were most commonly present, 85% of the bacteria isolated, and coagulase-negative staphylococci, especially St epidermidis, predominated (60%). Different species of streptococci, mostly of the viridans group, were isolated in 22% of the blood cultures attained in the first febrile episodes. The mortality due to infection in the series as a whole was 4.8%. CONCLUSIONS: Infections by gram-positive germs, especially coagulase-negative staphylococci, are commonly found among the patients subjected to bone-marrow transplantation. Increased streptococci infections, mostly of the viridans group, are also appreciated. These facts, along with decreased number of gram-negative infections, must be born in mind when designing initial antimicrobial coverage for these patients.