Possible nosocomial transmission of virus-associated hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation

Adenovirus (ADV)- or BK virus (BKV)-associated hemorrhagic cystitis (HC) is a common complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Several risk factors have been previously reported; however, it unclear whether virus-associated HC can be transmitted. To clarify this point, we performed retrospective cohort study on 207 consecutive patients who underwent allo-HSCT at Kyoto University Hospital between 2012 and 2018. We evaluated the incidence of phylogenetic analysis ADV partial sequence. The median age was 50 (range, 17–68) years. Fifty-eight (28%) developed HC. ADVs were detected in 18 cases, BKVs 51, both 12, only John Cunningham (JCV) 1 case. No factor significantly associated with However, ADV- BKV-HC occurred intensively April 2016 September 2017, which suggested possible nosocomial transmission BKV. Genome sequencing hexon, E3, penton regions identified 7 cases type 11, 2 35, 3 79-related strain. A sequence revealed that these strains each almost identical, except for one case In conclusion, ADV-HCs described based genotyping viral genome. Although thought to mainly due reactivation latent virus, BKV should also considered.