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Intestinal aGVHD and infection after hematopoietic stem cell transplantation

Cai-yan Hou, Li-li Xu, Hu Chen, Na Liu, Ming Jiang, Guo-quan Wang, Linlin Zhang, Xiao-hong Wang, Yan-jun Zeng

The 307th Hospital of PLA, Beijing, China (mainland)

Med Sci Monit 2013; 19:802-806

DOI: 10.12659/MSM.889408

Available online:

Published: 2013-09-30

Background: We aimed to guide clinical nursing by studying the relationship between intestinal acute graft-versus-host disease and intestinal infection after hematopoietic stem cell transplantation.
Material and Methods: We present an effective nursing method by comparing and analyzing the degree, duration time, and volume of diarrhea, and the distribution of pathogens in 44 patients who developed intestinal aGVHD after hematopoietic stem cell transplantation (24 patients with no intestinal infection).
Results: 21.4% of patients with grade I–II intestinal aGVHD developed into intestinal infection and 87.5% of patients with grade III–IV intestinal aGVHD developed into intestinal infection (P<0.05). Higher mortality was found in the grade III–IV intestinal aGVHD patients with intestinal infection. Patient age had no effect on the incidence of GVHD according to our data (P<0.05). We found remarkable differences in the amount and duration of diarrhea between patients with and without intestinal infection (P<0.05). The most common pathogens cultivated were Candida glabrata (24%) and Candida albicans (22.67%).
Conclusions: The incidence of intestinal infection increased remarkably after intestinal aGVHD occurred. Severe aGVHD can easily lead to fungus infection. Nursing care can decrease the incidence of intestinal infection in aGVHD.

Keywords: Candidiasis, Invasive - pathology, Adult, Adolescent, China, Diarrhea - pathology, Graft vs Host Disease - diagnosis, Hematopoietic Stem Cell Transplantation - adverse effects, Incidence, Intestines - microbiology, Time Factors