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Article: Clinical significance of alimentary tract microbes in bone marrow transplant recipients

TitleClinical significance of alimentary tract microbes in bone marrow transplant recipients
Authors
Issue Date1998
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/diagmicrobio
Citation
Diagnostic Microbiology And Infectious Disease, 1998, v. 30 n. 2, p. 75-81 How to Cite?
AbstractA prospective study on the microbes isolated from the alimentary tract in 120 bone marrow transplant (BMT) recipients (1991-1993) was undertaken to define the spectrum of organisms isolated under antimicrobial prophylaxis, their temporal sequence of emergence, and the associated morbidity and mortality. Clostridium difficile (n = 20), isolated in the pre-engraftment and early post-engraftment periods (day 2-45 post-BMT), was the most common microbe recovered from stool of patients with diarrhea. In contrast to previous reports, no significant difference in mortality was observed between patients with and without C. difficile isolated in stool. Two patients had neutropenic ileocecitis with concomitant bacteremia due to Escherichia coli and Klebsiella pneumoniae. One patient was found to have astrovirus gastroenteritis (day 7), and Giardia lamblia was recovered from the stool of another (day -7). Heavy growth of Staphylococcus aureus from direct smear-positive specimens was found from the upper airway of two patients with severe mucositis and complete dysplagia (day 12 and 23). Salmonella spp. of groups B and E were found in the stool of five asymptomatic patients at the time of conditioning. No specific organisms was recovered from the endoscopic brushing of two patients with lower end esophagitis, three patients with upper gastrointestinal bleeding, and three patients with perirectal cellulitis. During the post-engraftment period, five patients had documented cytomegalovirus gastroenterocolitis (days 34-97), one had Mycobacterium chelonae colitis (day 70), and another had nodular gastritis due to Acremonium falciforme (day 270). Overall, only 28% of patients with alimentary tract symptoms/syndrome had specific pathogens isolated from clinical specimens. Differentiation of the causation of alimentary tract symptoms was often difficult because noninfections complications such as conditioning toxicity, graft-versus-host disease, and its treatment often caused alimentary tract symptoms in addition to predisposed BMT patient to infection. The reluctance of obtaining tissue biopsy for ascertaining the importance of those potential alimentary tract pathogens often dictate the use of empirical treatment.
Persistent Identifierhttp://hdl.handle.net/10722/77612
ISSN
2015 Impact Factor: 2.45
2015 SCImago Journal Rankings: 1.142
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYuen, KYen_HK
dc.contributor.authorWoo, PCYen_HK
dc.contributor.authorLiang, RHSen_HK
dc.contributor.authorChiu, EKWen_HK
dc.contributor.authorChen, FFEen_HK
dc.contributor.authorWong, SSYen_HK
dc.contributor.authorLau, YLen_HK
dc.contributor.authorHa, SYen_HK
dc.contributor.authorPeiris, JSMen_HK
dc.contributor.authorSiau, Hen_HK
dc.contributor.authorChan, TKen_HK
dc.date.accessioned2010-09-06T07:33:47Z-
dc.date.available2010-09-06T07:33:47Z-
dc.date.issued1998en_HK
dc.identifier.citationDiagnostic Microbiology And Infectious Disease, 1998, v. 30 n. 2, p. 75-81en_HK
dc.identifier.issn0732-8893en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77612-
dc.description.abstractA prospective study on the microbes isolated from the alimentary tract in 120 bone marrow transplant (BMT) recipients (1991-1993) was undertaken to define the spectrum of organisms isolated under antimicrobial prophylaxis, their temporal sequence of emergence, and the associated morbidity and mortality. Clostridium difficile (n = 20), isolated in the pre-engraftment and early post-engraftment periods (day 2-45 post-BMT), was the most common microbe recovered from stool of patients with diarrhea. In contrast to previous reports, no significant difference in mortality was observed between patients with and without C. difficile isolated in stool. Two patients had neutropenic ileocecitis with concomitant bacteremia due to Escherichia coli and Klebsiella pneumoniae. One patient was found to have astrovirus gastroenteritis (day 7), and Giardia lamblia was recovered from the stool of another (day -7). Heavy growth of Staphylococcus aureus from direct smear-positive specimens was found from the upper airway of two patients with severe mucositis and complete dysplagia (day 12 and 23). Salmonella spp. of groups B and E were found in the stool of five asymptomatic patients at the time of conditioning. No specific organisms was recovered from the endoscopic brushing of two patients with lower end esophagitis, three patients with upper gastrointestinal bleeding, and three patients with perirectal cellulitis. During the post-engraftment period, five patients had documented cytomegalovirus gastroenterocolitis (days 34-97), one had Mycobacterium chelonae colitis (day 70), and another had nodular gastritis due to Acremonium falciforme (day 270). Overall, only 28% of patients with alimentary tract symptoms/syndrome had specific pathogens isolated from clinical specimens. Differentiation of the causation of alimentary tract symptoms was often difficult because noninfections complications such as conditioning toxicity, graft-versus-host disease, and its treatment often caused alimentary tract symptoms in addition to predisposed BMT patient to infection. The reluctance of obtaining tissue biopsy for ascertaining the importance of those potential alimentary tract pathogens often dictate the use of empirical treatment.en_HK
dc.languageengen_HK
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/diagmicrobioen_HK
dc.relation.ispartofDiagnostic Microbiology and Infectious Diseaseen_HK
dc.rightsDiagnostic Microbiology and Infectious Disease. Copyright © Elsevier Inc.en_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAntibiotic Prophylaxisen_HK
dc.subject.meshBone Marrow Transplantationen_HK
dc.subject.meshChilden_HK
dc.subject.meshChild, Preschoolen_HK
dc.subject.meshDiarrhea - microbiologyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshGastrointestinal Diseases - microbiologyen_HK
dc.subject.meshGram-Positive Bacteria - isolation & purificationen_HK
dc.subject.meshGram-Positive Bacterial Infections - microbiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshInfanten_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshProspective Studiesen_HK
dc.titleClinical significance of alimentary tract microbes in bone marrow transplant recipientsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0732-8893&volume=30&spage=75&epage=81&date=1998&atitle=Clinical+significance+of+alimentary+tract+microbes+in+bone+marrow+transplant+recipientsen_HK
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hken_HK
dc.identifier.emailWoo, PCY: pcywoo@hkucc.hku.hken_HK
dc.identifier.emailLiang, RHS: rliang@hku.hken_HK
dc.identifier.emailWong, SSY: samsonsy@hkucc.hku.hken_HK
dc.identifier.emailLau, YL: lauylung@hku.hken_HK
dc.identifier.emailPeiris, JSM: malik@hkucc.hku.hken_HK
dc.identifier.authorityYuen, KY=rp00366en_HK
dc.identifier.authorityWoo, PCY=rp00430en_HK
dc.identifier.authorityLiang, RHS=rp00345en_HK
dc.identifier.authorityWong, SSY=rp00395en_HK
dc.identifier.authorityLau, YL=rp00361en_HK
dc.identifier.authorityPeiris, JSM=rp00410en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0732-8893(97)00213-7en_HK
dc.identifier.pmid9554172-
dc.identifier.scopuseid_2-s2.0-0031913648en_HK
dc.identifier.hkuros37006en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0031913648&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume30en_HK
dc.identifier.issue2en_HK
dc.identifier.spage75en_HK
dc.identifier.epage81en_HK
dc.identifier.isiWOS:000072265700001-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridYuen, KY=36078079100en_HK
dc.identifier.scopusauthoridWoo, PCY=7201801340en_HK
dc.identifier.scopusauthoridLiang, RHS=26643224900en_HK
dc.identifier.scopusauthoridChiu, EKW=36848175600en_HK
dc.identifier.scopusauthoridChen, FFE=25928259900en_HK
dc.identifier.scopusauthoridWong, SSY=13310021400en_HK
dc.identifier.scopusauthoridLau, YL=7201403380en_HK
dc.identifier.scopusauthoridHa, SY=36945554600en_HK
dc.identifier.scopusauthoridPeiris, JSM=7005486823en_HK
dc.identifier.scopusauthoridSiau, H=16751930400en_HK
dc.identifier.scopusauthoridChan, TK=7402687762en_HK

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