662. Rhinovirus Infections (RhVI) in 233 Hematopoietic Cell Transplant (HCT) Recipients: A Single Center Experience
Session: Poster Abstract Session: Oh, Those Pesky Viruses!
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • poster - hRV ID week (003).pdf (419.9 kB)
  • Background: rhinovirus is a very common cause of respiratory viral infection in the general population and immunocompromised patients; however, data on clinical significance of these infections in HCT recipients remains scarce.

    Methods: In this retrospective study, we examined the epidemiology, demographics, clinical course and outcomes of RhVI diagnosed by RT-PCR in nasal wash samples from 233 HCT recipients at our institution between July 2014 and December 2015.

    Results: Majority of pts were Caucasians (64%), male (62%), with a median age of 55 years (range: 21- 79) and 60% were allograft recipients with unrelated (59), haploidentical (26), and match-related (73) donors. Of 233 pts, 177 (76%) with upper respiratory tract infection (URI) and 56 (24%) were diagnosed with lower respiratory tract infection (LRI). The frequency of LRI was similar among allogeneic (23%) and autologous (24%) HCT recipients. Nosocomial infection occurred in 25 (11%) pts and the majority within 100 d of HCT (18 [72%]) and before engraftment (14 [56%]). When compared to pts with URI, more pts with LRI had lymphopenia (absolute lymphocyte count <200), hypoxia at presentation (saO2 <92%), nosocomial infection, and were hospitalized (P<0.05, each). Only 2 pts with LRI (1%) died within 30 d from presentation. Among the 119 patients with repeated nasal washes, 60 (50%) had shedding of > 14 d with a median duration of 118 d (range: (16 - 510 days) and occurring in 41/80 (51%) pts with URI and in 19/39 (49%) pts with LRI.

    Conclusion: Our study showed that despite a high rate of LRI, the subsequent mortality in HCT recipients with RhVI remains relatively low. However, the long duration of shedding and the risk for nosocomial acquisition with subsequent LRI underscore the importance of strict infection control measures in this population.

    Mahnaz Taremi, MD, MPH1, Dimpy Shah, MD, MSPH, PhD1, Danielle El-Haddad, MD1, Firas El Chaer, MD2, Lynn El Haddad, PhD3, Amrita Prayag, M.B.B.S., MS4, Gabriela Rondon, MD5, Chitra Hosing, MD5, Ella Ariza-Heredia, MD6 and Roy F. Chemaly, MD, MPH, FIDSA, FACP6, (1)Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston, TX, (2)Infectious Diseases, Baylor College of Medicine, Houston, TX, (3)The University of Texas MD Anderson Cancer Center, Houston, TX, (4)Infectious Diseases, University of Texas MD Anderson Cancer Center, Houston, TX, (5)Stem Cell Transplantation Research, The University of Texas MD Anderson Cancer Center, Houston, TX, (6)Infectious Diseases, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX

    Disclosures:

    M. Taremi, None

    D. Shah, None

    D. El-Haddad, None

    F. El Chaer, None

    L. El Haddad, None

    A. Prayag, None

    G. Rondon, None

    C. Hosing, None

    E. Ariza-Heredia, None

    R. F. Chemaly, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.