Abstracto

Prevalence and risk factors of severe bacterial infections in thalassemia patients.

Fatma S. Alzhrani*, Fatima A. Algethmi, Manar A. Makin, Nujud A. Barayan, Rawan M. Hilal, Sarah Matouk Alnakhli

Background: Thalassemia is an inherited disease, and it is considered as one of the most common monogenic disorders that lead to chronic hemolytic anemia. Thalassemia is newly classified into non–transfusion-dependent thalassemia (NTDT), and transfusion-dependent thalassemia (TDT) based on the necessity of regular blood transfusions. Thalassemia major patients may need a chronic blood transfusion, iron chelation medication, and splenectomy as a part of their treatment. One of the most common causes of death in thalassemia patients is a bacterial infection. The predisposing factors of the infections are either related to the disease itself (e.g. anemia and reticuloendothelial system dysfunction) or to the treatment (e.g. splenectomy, transfusion-related infections, and iron chelation).

Aim: To determine the prevalence and risk factors of severe bacterial infections in NTDT and TDT thalassemia patients at a tertiary hospital

Method: A retrospective study was conducted on patients with NTDT & TDT. Records were scanned from 2014 to 2018 from the hematology department of a tertiary hospital, Jeddah, Saudi Arabia. Patients of all ages who had severe bacterial infection were included in this study.

Results: This study was applied to a total of 231 thalassemia patients at a tertiary hospital in Jeddah, Saudi Arabia. 119 (51.5%) of them were females, and 112 (48.5%) were males; the mean age was 22 years (± SD 13.3). The majority of the patients were TDT 214 (92.6%), and 17 (7.4%) were NTDT. A total of 38 ( 16.5%) thalassemic patients admitted due to bacterial infection. Most of the patients get infected by Escherichia coli, Staphylococcus aureus, and Klebsiella pneumoniae with the percentage of (24.1%, 13.8%, 13.8%), respectively.

Conclusion: In conclusion, Patients undergone splenectomies are not susceptible to bacterial infection. Deferoxamine or iron-chelating drugs does not increase the risk of bacterial infection in patients with thalassemia. Finally, a prophylactic antibiotic is not useful in decreasing bacterial infection in thalassemic patients.