Etiology of diarrhea in patients undergoing allogeneic bone marrow transplantation in South India

Gagandeep Kang, Alok Srivastava, Anna B. Pulimood, David Dennison, Mammen Chandy

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background. No studies so far have examined enteric infections in patients undergoing bone marrow transplantation (BMT) in developing countries where asymptomatic carriage and colonization with enteric pathogens is frequent. Methods. A prospective study followed 65 patients who underwent BMT in South India between 1995 and 1998. Patients were screened for enteric pathogens before transplantation, weekly during the first 4 weeks after transplantation, and during all episodes of diarrhea. Results. Enteric pathogens were found in 60% of patients before or after transplantation. Pretransplantation screening revealed asymptomatic excretion of enteric pathogens in 29% (19/65). Forty-eight percent of patients undergoing BMT developed diarrhea. Diarrhea was mainly of noninfectious origin in the first 20 days after transplantation. More than 20 days after transplantation, the major causes of diarrhea were graft-versus-host disease and infection. Parasitic infections other than Cryptosporidium did not contribute significantly to morbidity in the pre- and posttransplantation period. Rotavirus and adenoviruses were found in approximately 12% and 5% of subjects, respectively. Bacterial infections in the posttransplantation period were found to be more common in India than in developed countries. Clostridium difficile-associated diarrhea was seen in the posttransplantation period but not before transplantation. Enterotoxigenic and enterohemorrhagic Escherichia coli caused symptomatic infections in the posttransplantation period, but the association of other classes of diarrheogenic E. coli with diarrhea was doubtful. Conclusions. There was significantly higher mortality (P<0.01) in patients with symptomatic or asymptomatic gastrointestinal infections caused by bacteria than in patients with parasitic or viral infections or without enteric infections.

Original languageEnglish
Pages (from-to)1247-1251
Number of pages5
JournalTransplantation
Volume73
Issue number8
Publication statusPublished - Apr 27 2002

Fingerprint

Homologous Transplantation
Bone Marrow Transplantation
India
Diarrhea
Transplantation
Parasitic Diseases
Infection
Enterohemorrhagic Escherichia coli
Enterotoxigenic Escherichia coli
Cryptosporidium
Asymptomatic Infections
Clostridium difficile
Rotavirus
Graft vs Host Disease
Virus Diseases
Bacterial Infections
Developed Countries
Adenoviridae
Developing Countries
Prospective Studies

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Kang, G., Srivastava, A., Pulimood, A. B., Dennison, D., & Chandy, M. (2002). Etiology of diarrhea in patients undergoing allogeneic bone marrow transplantation in South India. Transplantation, 73(8), 1247-1251.

Etiology of diarrhea in patients undergoing allogeneic bone marrow transplantation in South India. / Kang, Gagandeep; Srivastava, Alok; Pulimood, Anna B.; Dennison, David; Chandy, Mammen.

In: Transplantation, Vol. 73, No. 8, 27.04.2002, p. 1247-1251.

Research output: Contribution to journalArticle

Kang, G, Srivastava, A, Pulimood, AB, Dennison, D & Chandy, M 2002, 'Etiology of diarrhea in patients undergoing allogeneic bone marrow transplantation in South India', Transplantation, vol. 73, no. 8, pp. 1247-1251.
Kang, Gagandeep ; Srivastava, Alok ; Pulimood, Anna B. ; Dennison, David ; Chandy, Mammen. / Etiology of diarrhea in patients undergoing allogeneic bone marrow transplantation in South India. In: Transplantation. 2002 ; Vol. 73, No. 8. pp. 1247-1251.
@article{ac31ec3700ab4a37a3ed4a2d8c1d60db,
title = "Etiology of diarrhea in patients undergoing allogeneic bone marrow transplantation in South India",
abstract = "Background. No studies so far have examined enteric infections in patients undergoing bone marrow transplantation (BMT) in developing countries where asymptomatic carriage and colonization with enteric pathogens is frequent. Methods. A prospective study followed 65 patients who underwent BMT in South India between 1995 and 1998. Patients were screened for enteric pathogens before transplantation, weekly during the first 4 weeks after transplantation, and during all episodes of diarrhea. Results. Enteric pathogens were found in 60{\%} of patients before or after transplantation. Pretransplantation screening revealed asymptomatic excretion of enteric pathogens in 29{\%} (19/65). Forty-eight percent of patients undergoing BMT developed diarrhea. Diarrhea was mainly of noninfectious origin in the first 20 days after transplantation. More than 20 days after transplantation, the major causes of diarrhea were graft-versus-host disease and infection. Parasitic infections other than Cryptosporidium did not contribute significantly to morbidity in the pre- and posttransplantation period. Rotavirus and adenoviruses were found in approximately 12{\%} and 5{\%} of subjects, respectively. Bacterial infections in the posttransplantation period were found to be more common in India than in developed countries. Clostridium difficile-associated diarrhea was seen in the posttransplantation period but not before transplantation. Enterotoxigenic and enterohemorrhagic Escherichia coli caused symptomatic infections in the posttransplantation period, but the association of other classes of diarrheogenic E. coli with diarrhea was doubtful. Conclusions. There was significantly higher mortality (P<0.01) in patients with symptomatic or asymptomatic gastrointestinal infections caused by bacteria than in patients with parasitic or viral infections or without enteric infections.",
author = "Gagandeep Kang and Alok Srivastava and Pulimood, {Anna B.} and David Dennison and Mammen Chandy",
year = "2002",
month = "4",
day = "27",
language = "English",
volume = "73",
pages = "1247--1251",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - Etiology of diarrhea in patients undergoing allogeneic bone marrow transplantation in South India

AU - Kang, Gagandeep

AU - Srivastava, Alok

AU - Pulimood, Anna B.

AU - Dennison, David

AU - Chandy, Mammen

PY - 2002/4/27

Y1 - 2002/4/27

N2 - Background. No studies so far have examined enteric infections in patients undergoing bone marrow transplantation (BMT) in developing countries where asymptomatic carriage and colonization with enteric pathogens is frequent. Methods. A prospective study followed 65 patients who underwent BMT in South India between 1995 and 1998. Patients were screened for enteric pathogens before transplantation, weekly during the first 4 weeks after transplantation, and during all episodes of diarrhea. Results. Enteric pathogens were found in 60% of patients before or after transplantation. Pretransplantation screening revealed asymptomatic excretion of enteric pathogens in 29% (19/65). Forty-eight percent of patients undergoing BMT developed diarrhea. Diarrhea was mainly of noninfectious origin in the first 20 days after transplantation. More than 20 days after transplantation, the major causes of diarrhea were graft-versus-host disease and infection. Parasitic infections other than Cryptosporidium did not contribute significantly to morbidity in the pre- and posttransplantation period. Rotavirus and adenoviruses were found in approximately 12% and 5% of subjects, respectively. Bacterial infections in the posttransplantation period were found to be more common in India than in developed countries. Clostridium difficile-associated diarrhea was seen in the posttransplantation period but not before transplantation. Enterotoxigenic and enterohemorrhagic Escherichia coli caused symptomatic infections in the posttransplantation period, but the association of other classes of diarrheogenic E. coli with diarrhea was doubtful. Conclusions. There was significantly higher mortality (P<0.01) in patients with symptomatic or asymptomatic gastrointestinal infections caused by bacteria than in patients with parasitic or viral infections or without enteric infections.

AB - Background. No studies so far have examined enteric infections in patients undergoing bone marrow transplantation (BMT) in developing countries where asymptomatic carriage and colonization with enteric pathogens is frequent. Methods. A prospective study followed 65 patients who underwent BMT in South India between 1995 and 1998. Patients were screened for enteric pathogens before transplantation, weekly during the first 4 weeks after transplantation, and during all episodes of diarrhea. Results. Enteric pathogens were found in 60% of patients before or after transplantation. Pretransplantation screening revealed asymptomatic excretion of enteric pathogens in 29% (19/65). Forty-eight percent of patients undergoing BMT developed diarrhea. Diarrhea was mainly of noninfectious origin in the first 20 days after transplantation. More than 20 days after transplantation, the major causes of diarrhea were graft-versus-host disease and infection. Parasitic infections other than Cryptosporidium did not contribute significantly to morbidity in the pre- and posttransplantation period. Rotavirus and adenoviruses were found in approximately 12% and 5% of subjects, respectively. Bacterial infections in the posttransplantation period were found to be more common in India than in developed countries. Clostridium difficile-associated diarrhea was seen in the posttransplantation period but not before transplantation. Enterotoxigenic and enterohemorrhagic Escherichia coli caused symptomatic infections in the posttransplantation period, but the association of other classes of diarrheogenic E. coli with diarrhea was doubtful. Conclusions. There was significantly higher mortality (P<0.01) in patients with symptomatic or asymptomatic gastrointestinal infections caused by bacteria than in patients with parasitic or viral infections or without enteric infections.

UR - http://www.scopus.com/inward/record.url?scp=0037181680&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037181680&partnerID=8YFLogxK

M3 - Article

C2 - 11981416

AN - SCOPUS:0037181680

VL - 73

SP - 1247

EP - 1251

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 8

ER -