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An Outbreak of Invasive Aspergillosis Among Allogeneic Bone Marrow Transplants: A Case-Control Study

Published online by Cambridge University Press:  02 January 2015

Coleman Rotstein ,
K. Michael Cummings ,
John Tidings ,
Kathleen Killion ,
Eileen Powell ,
Tracy L. Gustafson  and
Donald Higby
Coleman Rotstein*
Affiliation:
Departments of Medical Oncology and Cancer Control and Epidemiology, Roswell Park Memorial Institute, Buffalo, New York Division of Infectious Diseases, State University of New York at Buffalo, Buffalo, New York Director of Infectious Disease Division, Bureau of Epidemiology, Texas Department of Health, Austin, Texas
K. Michael Cummings
Affiliation:
Departments of Medical Oncology and Cancer Control and Epidemiology, Roswell Park Memorial Institute, Buffalo, New York Division of Infectious Diseases, State University of New York at Buffalo, Buffalo, New York Director of Infectious Disease Division, Bureau of Epidemiology, Texas Department of Health, Austin, Texas
John Tidings
Affiliation:
Departments of Medical Oncology and Cancer Control and Epidemiology, Roswell Park Memorial Institute, Buffalo, New York Division of Infectious Diseases, State University of New York at Buffalo, Buffalo, New York Director of Infectious Disease Division, Bureau of Epidemiology, Texas Department of Health, Austin, Texas
Kathleen Killion
Affiliation:
Departments of Medical Oncology and Cancer Control and Epidemiology, Roswell Park Memorial Institute, Buffalo, New York Division of Infectious Diseases, State University of New York at Buffalo, Buffalo, New York Director of Infectious Disease Division, Bureau of Epidemiology, Texas Department of Health, Austin, Texas
Eileen Powell
Affiliation:
Departments of Medical Oncology and Cancer Control and Epidemiology, Roswell Park Memorial Institute, Buffalo, New York Division of Infectious Diseases, State University of New York at Buffalo, Buffalo, New York Director of Infectious Disease Division, Bureau of Epidemiology, Texas Department of Health, Austin, Texas
Tracy L. Gustafson
Affiliation:
Departments of Medical Oncology and Cancer Control and Epidemiology, Roswell Park Memorial Institute, Buffalo, New York Division of Infectious Diseases, State University of New York at Buffalo, Buffalo, New York Director of Infectious Disease Division, Bureau of Epidemiology, Texas Department of Health, Austin, Texas
Donald Higby
Affiliation:
Departments of Medical Oncology and Cancer Control and Epidemiology, Roswell Park Memorial Institute, Buffalo, New York Division of Infectious Diseases, State University of New York at Buffalo, Buffalo, New York Director of Infectious Disease Division, Bureau of Epidemiology, Texas Department of Health, Austin, Texas
*
Department of Medical Oncology, Roswell Park Memorial Institute, 666 Elm Street, Buffalo, NY 14263
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Abstract

Between April 1982 and March 1983,10 of 26 (38.4%) allogeneic bone marrow transplant recipients housed on a newly opened bone marrow transplant unit developed invasive aspergillosis. By contrast, between September 1977 and March 1982, only 3 of 46 (6%) transplant recipients developed invasive aspergillosis. A case-control study to identify host factors related to Aspergillus infection found that aspergillosis was more common in patients with chronic myelogenous leukemia and aplastic anemia, older patients, patients having cytomegalovirus disease, patients who experienced prolonged granulocytopenia, patients conditioned with ara-C (100-200 mg/day), and patients who received longer duration of antimicrobial therapy. A series of logistic regression analyses revealed that underlying disease was the single best predictor of Aspergillus infection. This study demonstrates that underlying disease is an important risk factor for aspergillosis and that special measures may be warranted when transplanting certain patients.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 6 , Issue 9 , September 1985 , pp. 347 - 355
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1985

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