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1、1291. Clinical Signifi cance of Human Coronavirus in Bronchoalveolar Lavage Samples From Hematopoietic Cell Transplantation Recipients and Hematologic Malignancy Patients Chikara Ogimi, MD1; Alpana Waghmare, MD2; Jane Kuypers, PhD3; Hu Xie, MS4; Wendy Leisenring, ScD5; Cecilia Yeung, MD5; Sachiko Se
2、o, MD5; Su-Mi Choi, MD, PhD6; Keith Jerome, MD, PhD7; Janet Englund, MD, FIDSA8; Michael Boeckh, MD, FIDSA7; 1Division of Pediatric Infectious Diseases, University of Washington, Seattle, Washington; 2University of Washington, Seattle, Washington;3Laboratory Medicine, University of Washington, Seatt
3、le, Washington; 4Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 5Fred Hutchinson Cancer Research Center, Seattle, Washington; 6Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; 7Vaccine and Infec
4、tious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 8Infectious Disease/CCTR, Seattle Childrens Hospital, Seattle, Washington Session: 139. Clinical Infectious Diseases: Respiratory Infections Friday, October 28, 2016: 12:30 PM Background.Fatal pneumonia attributed t
5、o human coronaviruses (HCoVs) in he- matopoietic cell transplant (HCT) recipients has been reported but systematic studies on the possible role of HCoV in lower respiratory tract disease (LRTD) in HCT and hematologic malignancy (HM) patients are limited. Methods.We conducted a retrospective review o
6、f HCT/HM patients with HCoV detected in bronchoalveolar lavage (BAL). HCoV strains were identifi ed in frozen BAL samples using strain-specifi c PCR. Mortality rates were compared among HCT recip- ients with LRTD caused by HCoV, respiratorysyncytial virus (RSV), infl uenza (Flu) or parainfl uenza vi
7、rus (PIV) without respiratory viral co-pathogens by multivariable Cox regression analysis. Results. We identifi ed 37 cases with HCoV in BAL (Table). Among 23 samples available, 48% were OC43, 22% were NL63, 17% were 229E and 13% were HKU1. Overall, 23 cases (62%) required oxygen (O2) therapy at dia
8、gnosis and 19 cases (51%) died within 90 days from diagnosis. Twenty-one cases (57%) had other respira- tory pathogen(s) detected, including viruses (N = 12), fungi (N = 10), and bacteria (N=8). Mortality rates of these patients were similar to those without co-pathogens (p-value 0.89). Multivariabl
9、e Cox regression for mortality adjusted for cell source, co-pathogens, neutrophils, lymphocytes, monocytes, O2 use at diagnosis, steroid use and respiratory viruses (HCoV, RSV, Flu and PIV) was carried out. Adjusted hazard ratio of HCoV LRTD for overall mortality was 1.37 (95% CI 0.67-2.82, p-value
10、0.39) with RSV LRTD as a reference. HCoV as Sole Respiratory Pathogen (N=16) HCoV Coinfected with Other Respiratory Pathogens (N=21) Demographics Female5 (31%)5 (24%) Age: median (range)55 (8-62)49 (26-68) HM patients43 HCT recipients1218 Cord01 Bone marrow24 Peripheral blood stem cell 1013 O2 requi
11、rement at diagnosis 9 (56%)14 (67%) Outcome Mechanical ventilation requirement within 10 days from diagnosis 3 (19%)4 (19%) Death at Day 90 from diagnosis 8 (50%)11 (52%) Conclusion.HCoV LRTD in HCT/HM patients is associated with high O2 re- quirement and mortality. Mortality associated with HCoV LR
12、TD in HCT recipients is similar to that seen with other respiratory viral pathogens including RSV, Flu and PIV. Disclosures. J. Englund, Pfi zer: Consultant and Investigator, Research support and Speaker honorarium. Gilead: Consultant and Investigator, Consulting fee and Re- search support. GlaxoSmithKline: Investigator and Member Data Safety Monitoring Board, Hourly payment for DSMB work and Research support. Alios: Investigator, Re- search support. Roche: Investigator, Research support Poster AbstractsOFID 2016:1 (0 Month)1 Downloaded from by guest on 26 October 2019
