Severe bacterial infections in patients with non-transfusion-dependent thalassemia: prevalence and clinical risk factors

Introduction: Bacterial infection is one of the major causes of death in patients with thalassemia. Clinical predictive factors for severe bacterial infection were evaluated in patients with non-transfusion-dependent thalassemia (NTDT). Methods: A retrospective study was conducted of patients with NTDT aged >= 10 years at Srinagarind Hospital, Khon Kaen University, Thailand. Clinical characteristics and potential clinical risk factors for bacterial infection were collected. Risk factors for bacterial infection were evaluated by multivariate logistic regression analysis. Results: A severe bacterial infection was found in 11 of the total 211 patients with NTDT (5.2%). None of the clinical factors assessed was shown to be statistically associated with severe bacterial infection in patients with NTDT. However, three factors were demonstrated to be potential predictive factors for severe bacterial infection: time after splenectomy > 10 years, deferoxamine therapy, and serum ferritin > 1000 ng/ml. None of the patients died from infection. Conclusion: The prevalence of bacterial infection in patients with NTDT was found to be moderate. Time after splenectomy > 10 years, deferoxamine therapy, and iron overload may be clinical risk factors for severe bacterial infection in patients with NTDT. Bacterial infection should be recognized in splenectomized patients with NTDT, particularly those who have an iron overload. (C) 2015 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.