1. ¹Infectious Diseases Unit, Department of Hematology and Oncology, G Gaslini Children Hospital, Genoa, Italy
2. ²Epidemiology and Biostatistics Section, Scientific Directorate, G Gaslini Children Hospital, Genoa, Italy
3. ³Bone Marrow Transplant Unit, Department of Hematology and Oncology, G Gaslini Children Hospital, Genoa, Italy
4. ⁴Immunohematology and Transfusion Medicine Service, Department of Hematology and Oncology, G Gaslini Children Hospital, Genoa, Italy

Correspondence: Dr E Castagnola, Infectious Diseases Unit, Department of hematology and Oncology, G Gaslini Children Hospital, Largo G Gaslini, 5, Genoa 16147, Italy. E-mail: eliocastagnola@ospedale-gaslini.ge.it

Received 13 June 2007; Revised 15 August 2007; Accepted 24 September 2007; Published online 19 November 2007.

Abstract

We performed a retrospective single center study to define the epidemiology of bacteremias or invasive mycoses in pediatric allogeneic hematopoietic SCT (HSCT) from matched related donors (MRD) or alternative donors (AD). During 119 213 days of follow-up, 156 infections were observed: 130 bacteremias (27 in MRD-HSCT and 103 in AD-HSCT recipients) and 26 invasive mycoses (8 in MRD-HSCT and 18 in AD-HSCT recipients). Overall, the risk of bacteremia was fivefold that of invasive mycosis (P<0.001). AD-HSCT recipients had a higher percentage of infections (89 vs 27%; P<0.001), a higher rate/100 days of immunosuppression (infection rate (IR): 0.21 vs 0.06; P<0.001) and a higher proportion of repeated infections (44 vs 9%; P=0.001). In AD-HSCT, the relative risk of bacteremia was 2.87 in the pre-engraftment period, 5.84 in the early post-engraftment period and 6.46 in the late post-engraftment period (P<0.001) compared to MRD-HSCT. Only after 1 year did the epidemiology become similar. The epidemiology of invasive mycoses did not differ significantly between the two types of transplant.