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Infections diagnosed in the first year after pediatric stem cell transplantation.

Publication ,  Journal Article
Benjamin, DK; Miller, WC; Bayliff, S; Martel, L; Alexander, KA; Martin, PL
Published in: Pediatr Infect Dis J
March 2002

BACKGROUND: Cumulative incidence of infections in the first year posttransplantation in adult patients has been well-described. Such description is less than complete for pediatric stem cell transplantation (SCT) patients. Further among those patients who have been infected, analysis of risk factors for infection has not been well-described for a large cohort of pediatric SCT patients. METHODS: We conducted a retrospective cohort study of infections in the first year after SCT at Duke University Medical Center. We recorded all infections in the first year after transplantation. We determined incidences for 6 categories of infection: gram-negative rods; gram-positive cocci; yeast species; Aspergillus sp.; adenovirus; and cytomegalovirus. We determined incidences based on type of transplant and days post transplantation. We also completed bivariable and multivariable analysis of risk factors [neutropenia, graft vs. host disease (GVHD) and GVHD treatment] for infection type among those children who were infected. RESULTS: We evaluated 510 transplants in 485 children. There were 584 infections in the first year after transplantation. During the first 30 days posttransplantation, type of transplantation did not predict incidence of infection or type of infection. After 30 days children who received unrelated cord blood transplant and matched unrelated donor transplant were at much higher risk of infection than were patients who received autologous, matched sibling or haploidentical transplant (P < 0.001). Patients who received unrelated cord blood or matched unrelated donor transplantation were at higher risk of aspergillosis (P = 0.002), candidiasis (P = 0.005) and adenovirus (P < 0.0001) but not cytomegalovirus (P = 0.18). In analysis of risk factors among those infected, patients with aspergillosis were more likely to have severe GVHD: multivariable 1 year risk ratio, 7.5; 95% confidence interval, 3.0, 18.4. Neutropenia was more strongly associated with gram-negative rod infection than any other type of infection. CONCLUSIONS: The incidence of infection immediately after transplantation did not differ significantly by type of transplant in this pediatric population. Type of transplant predicted increased incidence of infection 30 days posttransplantation and increased incidence of infection with several organisms traditionally associated with a high mortality rate in the transplant population.

Duke Scholars

Published In

Pediatr Infect Dis J

DOI

ISSN

0891-3668

Publication Date

March 2002

Volume

21

Issue

3

Start / End Page

227 / 234

Location

United States

Related Subject Headings

  • Virus Diseases
  • Risk Factors
  • Retrospective Studies
  • Pediatrics
  • Opportunistic Infections
  • North Carolina
  • Mycoses
  • Multivariate Analysis
  • Male
  • Infant, Newborn
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Benjamin, D. K., Miller, W. C., Bayliff, S., Martel, L., Alexander, K. A., & Martin, P. L. (2002). Infections diagnosed in the first year after pediatric stem cell transplantation. Pediatr Infect Dis J, 21(3), 227–234. https://doi.org/10.1097/00006454-200203000-00013
Benjamin, Daniel Kelly, William C. Miller, Sherry Bayliff, Lisa Martel, Kenneth A. Alexander, and Paul Langlie Martin. “Infections diagnosed in the first year after pediatric stem cell transplantation.Pediatr Infect Dis J 21, no. 3 (March 2002): 227–34. https://doi.org/10.1097/00006454-200203000-00013.
Benjamin DK, Miller WC, Bayliff S, Martel L, Alexander KA, Martin PL. Infections diagnosed in the first year after pediatric stem cell transplantation. Pediatr Infect Dis J. 2002 Mar;21(3):227–34.
Benjamin, Daniel Kelly, et al. “Infections diagnosed in the first year after pediatric stem cell transplantation.Pediatr Infect Dis J, vol. 21, no. 3, Mar. 2002, pp. 227–34. Pubmed, doi:10.1097/00006454-200203000-00013.
Benjamin DK, Miller WC, Bayliff S, Martel L, Alexander KA, Martin PL. Infections diagnosed in the first year after pediatric stem cell transplantation. Pediatr Infect Dis J. 2002 Mar;21(3):227–234.

Published In

Pediatr Infect Dis J

DOI

ISSN

0891-3668

Publication Date

March 2002

Volume

21

Issue

3

Start / End Page

227 / 234

Location

United States

Related Subject Headings

  • Virus Diseases
  • Risk Factors
  • Retrospective Studies
  • Pediatrics
  • Opportunistic Infections
  • North Carolina
  • Mycoses
  • Multivariate Analysis
  • Male
  • Infant, Newborn