Lack of evidence for a reciprocal interaction between bacterial and cytomegalovirus infection in the allogeneic stem cell transplantation setting

Transpl Int. 2016 Nov;29(11):1196-1204. doi: 10.1111/tri.12831. Epub 2016 Sep 13.

Abstract

Pathogenic interactions between bacteria and cytomegalovirus (CMV) may potentially occur early after allogeneic stem cell transplantation (allo-SCT). This possibility nevertheless has not been investigated in depth. This was a retrospective study that included 170 consecutive patients who underwent 173 allo-SCTs. Both bacterial infection (most of which were bacteremic) and CMV DNAemia were detected in 78 allo-SCTs (62.9%). In total, 51 and 32 episodes of bacterial infection preceded or occurred after CMV DNAemia detection, respectively. Both events were diagnosed concurrently in four allo-SCTs. The cumulative incidence of bacterial infection (of any type) over the study period was comparable in patients with or without a preceding episode of CMV DNAemia (P = 0.321). Cox proportional hazards regression analysis failed to identify CMV DNAemia as a significant risk factor for bacterial infection. Likewise, the cumulative incidence of CMV DNAemia within the study period was not significantly different in patients with or without a preceding episode of bacterial infection (P = 0.189). Furthermore, the occurrence of bacterial infection within episodes of active CMV infection had no apparent impact on the kinetics of CMV DNAemia. Our data, thus, do not support the existence of a bidirectional synergistic effect between bacterial infection and active CMV infection in the allo-SCT setting.

Keywords: CMV DNAemia; allogeneic stem cell transplantation; bacteremia; bacterial infection; cytomegalovirus.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bacteremia / complications
  • Bacterial Infections / complications*
  • Cytomegalovirus
  • Cytomegalovirus Infections / complications*
  • DNA, Viral / blood
  • Female
  • Follow-Up Studies
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Transplantation, Homologous / adverse effects
  • Young Adult

Substances

  • DNA, Viral