Please use this identifier to cite or link to this item: http://cmuir.cmu.ac.th/jspui/handle/6653943832/62956
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dc.contributor.authorRapee Lertpongpiroonen_US
dc.contributor.authorEkarat Rattarittamrongen_US
dc.contributor.authorThanawat Rattanathammetheeen_US
dc.contributor.authorChatree Chai-Adisaksophaen_US
dc.contributor.authorAdisak Tantiworawiten_US
dc.contributor.authorParichat Saleeen_US
dc.contributor.authorLalita Norasetthadaen_US
dc.date.accessioned2018-12-14T03:45:57Z-
dc.date.available2018-12-14T03:45:57Z-
dc.date.issued2018-12-04en_US
dc.identifier.issn20521839en_US
dc.identifier.other2-s2.0-85057604060en_US
dc.identifier.other10.1186/s12878-018-0129-9en_US
dc.identifier.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85057604060&origin=inwarden_US
dc.identifier.urihttp://cmuir.cmu.ac.th/jspui/handle/6653943832/62956-
dc.description.abstract© 2018 The Author(s). Background: Infection is a major complication in aplastic anemia (AA) patients. Primary objectives of this study were to determine the prevalence of infections and to determine types of pathogens associated with infections in patients with AA. Secondary objectives were to evaluate overall survival after infections as well as risk factors of infections in patients with AA. Methods: The authors retrospectively evaluated the infectious episodes (IEs), type of infections, associated pathogens, and outcomes of infections in patients with AA who were diagnosed and treated at Chiang Mai University between January 2010 and December 2015. Results: Sixty-seven patients with a median age of 51 years (range, 15-87 years) were enrolled. Forty two patients (62.6%) were severe AA. Median absolute neutrophil count (ANC) was 984 /mm3 (range, 120-5500/mm3). Twenty five patients (37.3%) received antithymocyte globulin plus cyclosporine A, 41 patients (61.1%) received anabolic hormone, and 2 patients (2.9%) underwent allogeneic hematopoietic stem cell transplantation. Overall, 31 IEs were documented in 22 patients (32.8%). The most common microbiologically documented site of infection was bloodstream infection (23.4%) followed by pulmonary infection (14.9%). Culture-negative febrile neutropenia occurred in 12.7%. Common pathogens identified were bacteria (73.9%), mainly gram-negative (52.9%) including Acinetobacter baumannii (23.5%) and Pseudomonas aeruginosa (17.6%). Fungal infections were diagnosed in 21.7% and all were Aspergillus spp. Six patients (9%) died during the study period. All of them died from infection which gram-negative bacteria were most common pathogens (66.7%). Patients with infections had 5-year overall survival of 72% that is significantly less than patients without infection (100%) (p = 0.0002). Only risk factor that correlates with high probability of infection was ANC < 500/mm3. (HR 2.29, 95%CI 1.03-7.72, p = 0.043). Conclusions: Prevalence of infections in AA patients in Chiang Mai University was 32.8% Bacterial infections especially gram-negative bacteria were the major pathogens. Patients with ANC < 500/mm3 had higher risk of infections. Infection was the most important cause of death in AA.en_US
dc.subjectBiochemistry, Genetics and Molecular Biologyen_US
dc.subjectMedicineen_US
dc.titleInfections in patients with aplastic Anemia in Chiang Mai Universityen_US
dc.typeJournalen_US
article.title.sourcetitleBMC Hematologyen_US
article.volume18en_US
article.stream.affiliationsChiang Mai Universityen_US
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