Low CD4 count may be a risk factor for non-tuberculous mycobacteria infection in pediatric hematopoietic cell transplant recipients
| Autor: | Zhezhen Jin, Prakash Satwani, Monica Bhatia, Courtney Baker, Marc D Foca, James Garvin, Holly M. Wobma, Alicia K. Chang, Diane George |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Adolescent 030232 urology & nephrology Patient characteristics Graft vs Host Disease Mycobacterium Infections Nontuberculous Disease 030230 surgery Opportunistic Infections Azithromycin 03 medical and health sciences Immunocompromised Host 0302 clinical medicine Immune system Acquired immunodeficiency syndrome (AIDS) Risk Factors Internal medicine Medicine Humans Risk factor Child Retrospective Studies Transplantation Hematopoietic cell business.industry Potential risk Incidence Hematopoietic Stem Cell Transplantation Infant bacterial infections and mycoses medicine.disease CD4 Lymphocyte Count Case-Control Studies Child Preschool Pediatrics Perinatology and Child Health Female business Immunosuppressive Agents medicine.drug Follow-Up Studies |
| Zdroj: | Pediatric transplantationREFERENCES. 25(4) |
| ISSN: | 1399-3046 |
| Popis: | BACKGROUND HCT leaves patients in a relative state of immune deficiency both during their initial transplant admission and for several years following discharge. NTM are generally harmless colonizers of the outside environment, but for immunocompromised patients, they can cause significant disease due to a paucity of T-cell defense. While routine prophylaxis against NTM is recommended for patients with low CD4 counts in certain clinical settings (eg, AIDS), this is not yet established for HCT patients despite their higher risk. METHODS Here we build upon our prior work to determine risk factors for NTM in pediatric HCT patients by comparing NTM patient characteristics to matched HCT controls. RESULTS We followed 272 patients across a 13-year time period, with 11 cases of NTM. Patients with NTM had a significantly lower CD4 count at Day 365 than matched HCT controls (105.5 ± 97.0 cells/µl vs. 856.2 ± 446.1 cells/µl, respectively; p = .001). No other potential risk factors (eg, CMV, GvHD, disease type) were found to be statistically significant, including use of T-cell depleting agents. This is consistent with an average diagnosis of NTM at Day +323 (ie, outside immediate post-transplant period). All-cause mortality was similar between NTM and control HCT groups, with an NTM attributable mortality of |
| Databáze: | OpenAIRE |
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