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35th Annual Meeting of the European Group for Blood and Marrow Transplantation
25th Meeting of the EBMT Nurses Group
8th Meeting of the EBMT Data Management Group
3rd Patient & Family Day
Göteborg, Sweden
29.03.2009 - 01.04.2009 |
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Infectious complicationsTuesday, March 31, 2009, 17:30 - 19:00Risk of bacterial contamination at autologous peripheral blood stem cell collection and infusionA. Yilmaz, E. Ayyildiz, M. Bay, A. Azap, G. Gürman, Ö. Arslan, O. Ilhan, M. Arat (Ankara, TR)
Background: Peripheral blood stem cells (PBSC) are the major stem cell source for autologous stem cell transplantation. Bacterial contamination (BC) of the collected PBSC is a major problem, which is seldomly reported. The multi-stage processing of autoPBSC till infusion incapacitates hazards for BC. There are several published reports about BC but its impact on mortality and morbidity is seldomly shared. In our single center prospective non-controlled study we aimed to determine the source of contamination at all possible stages and its clinical relevance.
Patients and Methods: Our center is performing more than 100 leukopheresis and SCT per year. Candidates for autoPBSC transplantation are consecutively entered into this study. We analyzed 30 completed leukopheresis procedures on 18 patients, whose median age was 52 y(range, 25-68) with diagnoses of lymphoma and myeloma. One ml. samples were collected into the BD Bactec Ped/Plus Aerobic&Anaerobic blood culture bottles at the following stages in aspetic conditions: before and after leukopheresis from peripheral vein or from both catheter arms, in collected PBSC, just before cryopreservation from the cryobags, just after thawing at the time of infusion. Bacteriological examination was performed by BACTEC 9050 blood culture system. Growing microorganisms (MO)were identified using conventional methods and gr(+)crystal ID Kit.
Results: We identified MO in 12 PBSC procedures of 10 patients. The majority was gr(+) cocci (%77.7) as expected and gr(-) bacilli (%22.3). Gr(+) MO were staph. epidermidis (%85.7), staphylococcus heamolyticus (%14.3) and all of the gr(-) bacilli isolated were pseud. aeroginosa. The stages of bacterial growth are depicted in table 1. The major stage for contamination was leukopheresis procedure, followed by preparation of cryosolution and thawing. The majority of the MO grown at the primary stages were not identified after thawing. Only in 4/30 procedures we identified MO in infused PBSC. They did not develop any relevant infectious complications during peritransplant period.
Conclusion: Collection of autoPBSC and transplantation are multistage consecutive procedures, which are prone to bacterial contamination. The contamination risk during leukopheresis was higher than expected and gr(+) MO in the majority. After cryopreservation only in a minority of infusions we detected bacterial contamination which did not develop significant clinical infectious episodes of the same MO.
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