Infectious Diseases

Definitions

One important feat achieved over the past few years is the Definitions of Infections after a HSCT. A Definitions Subcommittee was set-up during EBMT 2005 in Prague.

We hope to be able to publish our proposals in a peer-reviewed journal as soon as possible. These guidelines will help data managers introduce ID-related data in the EBMT registry and will also make the data of greater quality due to homogeneity in definition.

Definitions of Infectious Diseases and Complications after Stem Cell Transplant

A proposal from the Infectious Diseases Working Party
1 November 2001
Version 1

Catherine Cordonnier, Dan Engelhard, Per Ljungman, Adrian Dekker, J.P. Donnelly, Hermann Einsele, Ernst Holler, Hartmut Link, Anna Locasiulli, Rodrigo Martino, Fritz Offner, Pierre Reusser, Montserrat Rovira, Andrew Ullman, Kate Ward

On behalf of the Infectious Diseases Working Party of the EBMT.

To download full document, please click here.

Notes on Definitions

In the past, some confusion and variability in reporting has been noted with significant differences in incidences of infection among centres which may not be accurate. The growing knowledge of infectious complications after stem cell transplant makes it important that investigators agree on common definitions in the reporting of data, to insure that series are comparable.

This proposal aims to provide standard definitions for infectious complications occurring after stem cell transplantation within the EBMT. This should be useful for two purposes:

• to make the data given to the EBMT Registry more precise and common to all the centres. This should improve data management, insure the quality of the data in the EBMT centres and facilitate prospective and retrospective studies through the registry. Although these definitions are not fully exhaustive and will probably evolve in the future, the Infectious Diseases Working Party and the Registry Committee recommend the EBMT members use the present version of these definitions when filling the infection-related complication section in the MED B forms.
  
  
• to provide official definitions for the Group, so that authors may refer to these definitions for studies or surveys, including those done outside the registry. It is not the purpose of this text to force the EBMT members to use these definitions, but only to facilitate their work, so that they may choose, when publishing on a topic, between refering to the EBMT definitions, or to others.

These definitions are drawn either from published guidelines whenever possible, or from the consensus emerging from the members of the Infectious Diseases Working Party when no satisfactory definition has previously been proposed in the literature.

These definitions are presented in two parts:

• the first part summarizes the different clinical entities which are usually observed. Most of these entities - but not all - are intended for entering infectious complications in the EBMT data base.
  
• the second part covers definitions regarding specific pathogens: bacteria, fungi, viruses, others. Most of the items concern clinical entities defined in the first part, and aim to help the investigator to establish the relationship between the clinical presentation, and the role of a pathogen. We have restricted the definitions to the most difficult items and do not mention obvious definitions of widely accepted infections or diseases.
  
  Because of the introduction of more and more sensitive tests to detect pathogens, the definitions should be as clear as possible concerning the diagnostic value of each new test in a given clinical setting. It is clear that definitions for infectious diseases or syndromes may evolve with the progress of investigative procedures, or understanding of the disease. Therefore, once a consensus is obtained, these definitions should be reviewed every two years, or more often where necessary. EBMT members are encouraged to make suggestions on this version to the chairperson of the IDWP.