The association of CMV infection with bacterial and fungal infections in hematopoietic stem cell transplant recipients: a retrospective single-center study

This study aims to evaluate the probable association between CMV infection and bacterial or fungal infections in 91 consecutive adult patients who underwent autologous or allogeneic HSCT within a period of two years. The medical records of the patients were retrospectively reviewed. Blood cultures were evaluated by an automated blood culture system. A quantitative real-time polymerase chain reaction was performed to detect CMV DNA. CMV infection and CMV disease were detected in 42 (46%) and six (6.6%) patients, respectively. Of the 158 microorganisms isolated, 115 (73%) were Gram-positive bacteria. Bacteremia and fungemia developed in 55 (60%) and eight (8%) patients, respectively. Concurrent CMV infection and bacteremia were detected in 17 (18.7%) patients and concurrent CMV infection and fungal infection were detected in five (5.5%) patients. Graft versus host disease (GVHD) developed in 15 (50%) allogeneic HSCT recipients and two (2.2%) autologous HSCT recipients. Twenty-one (23%) patients including 13 (43%) allogeneic and eight (13%) autologous HSCT recipients died. The most common infection is bacteremia, and it develops concurrently with CMV infection in approximately one-fifth of HSCT recipients. Gram-positive bacteria are more common in bacteremia. Further studies on the follow-up and treatment of infections after HSCT will improve post-HSCT survival rates.