Skip to main content
Journal cover image

Microbiology and Risk Factors for Hospital-Associated Bloodstream Infections Among Pediatric Hematopoietic Stem Cell Transplant Recipients.

Publication ,  Journal Article
Akinboyo, IC; Young, RR; Spees, LP; Heston, SM; Smith, MJ; Chang, Y-C; McGill, LE; Martin, PL; Jenkins, K; Lugo, DJ; Hazen, KC; Seed, PC; Kelly, MS
Published in: Open Forum Infect Dis
April 2020

BACKGROUND: Children undergoing hematopoietic stem cell transplantation (HSCT) are at high risk for hospital-associated bloodstream infections (HA-BSIs). This study aimed to describe the incidence, microbiology, and risk factors for HA-BSI in pediatric HSCT recipients. METHODS: We performed a single-center retrospective cohort study of children and adolescents (<18 years of age) who underwent HSCT over a 20-year period (1997-2016). We determined the incidence and case fatality rate of HA-BSI by causative organism. We used multivariable Poisson regression to identify risk factors for HA-BSI. RESULTS: Of 1294 patients, the majority (86%) received an allogeneic HSCT, most commonly with umbilical cord blood (63%). During the initial HSCT hospitalization, 334 HA-BSIs occurred among 261 (20%) patients. These were classified as gram-positive bacterial (46%), gram-negative bacterial (24%), fungal (12%), mycobacterial (<1%), or polymicrobial (19%). During the study period, there was a decline in the cumulative incidence of HA-BSI (P = .021) and, specifically, fungal HA-BSIs (P = .002). In multivariable analyses, older age (incidence rate ratio [IRR], 1.03; 95% confidence interval [CI], 1.01-1.06), umbilical cord blood donor source (vs bone marrow; IRR, 1.69; 95% CI, 1.19-2.40), and nonmyeloablative conditioning (vs myeloablative; IRR, 1.85; 95% CI, 1.21-2.82) were associated with a higher risk of HA-BSIs. The case fatality rate was higher for fungal HA-BSI than other HA-BSI categories (21% vs 6%; P = .002). CONCLUSIONS: Over the past 2 decades, the incidence of HA-BSIs has declined among pediatric HSCT recipients at our institution. Older age, umbilical cord blood donor source, and nonmyeloablative conditioning regimens are independent risk factors for HA-BSI among children undergoing HSCT.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Open Forum Infect Dis

DOI

ISSN

2328-8957

Publication Date

April 2020

Volume

7

Issue

4

Start / End Page

ofaa093

Location

United States

Related Subject Headings

  • 3207 Medical microbiology
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Akinboyo, I. C., Young, R. R., Spees, L. P., Heston, S. M., Smith, M. J., Chang, Y.-C., … Kelly, M. S. (2020). Microbiology and Risk Factors for Hospital-Associated Bloodstream Infections Among Pediatric Hematopoietic Stem Cell Transplant Recipients. Open Forum Infect Dis, 7(4), ofaa093. https://doi.org/10.1093/ofid/ofaa093
Akinboyo, Ibukunoluwa C., Rebecca R. Young, Lisa P. Spees, Sarah M. Heston, Michael J. Smith, Yeh-Chung Chang, Lauren E. McGill, et al. “Microbiology and Risk Factors for Hospital-Associated Bloodstream Infections Among Pediatric Hematopoietic Stem Cell Transplant Recipients.Open Forum Infect Dis 7, no. 4 (April 2020): ofaa093. https://doi.org/10.1093/ofid/ofaa093.
Akinboyo IC, Young RR, Spees LP, Heston SM, Smith MJ, Chang Y-C, et al. Microbiology and Risk Factors for Hospital-Associated Bloodstream Infections Among Pediatric Hematopoietic Stem Cell Transplant Recipients. Open Forum Infect Dis. 2020 Apr;7(4):ofaa093.
Akinboyo, Ibukunoluwa C., et al. “Microbiology and Risk Factors for Hospital-Associated Bloodstream Infections Among Pediatric Hematopoietic Stem Cell Transplant Recipients.Open Forum Infect Dis, vol. 7, no. 4, Apr. 2020, p. ofaa093. Pubmed, doi:10.1093/ofid/ofaa093.
Akinboyo IC, Young RR, Spees LP, Heston SM, Smith MJ, Chang Y-C, McGill LE, Martin PL, Jenkins K, Lugo DJ, Hazen KC, Seed PC, Kelly MS. Microbiology and Risk Factors for Hospital-Associated Bloodstream Infections Among Pediatric Hematopoietic Stem Cell Transplant Recipients. Open Forum Infect Dis. 2020 Apr;7(4):ofaa093.
Journal cover image

Published In

Open Forum Infect Dis

DOI

ISSN

2328-8957

Publication Date

April 2020

Volume

7

Issue

4

Start / End Page

ofaa093

Location

United States

Related Subject Headings

  • 3207 Medical microbiology
  • 3202 Clinical sciences