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Published on: September 6, 2017
Risk factor analysis of bloodstream infection in pediatric patients after hematopoietic stem cell transplantation
Takeo Sarashina1, Makoto Yoshida, Akihiro Iguchi
1Department of Paediatrics, Asahikawa Medical University, Asahikawa, Japan. sara5p@asahikawa-med.ac.jp
Insights
Bloodstream infections (BSI) pose risks for children undergoing hematopoietic stem cell transplantation (HSCT). Aplastic anemia and Wiskott-Aldrich syndrome are identified as novel risk factors for BSI in these pediatric patients.
Area of Science:
- Pediatric Hematology
- Infectious Diseases
- Transplantation Medicine
Background:
- Bloodstream infection (BSI) is a significant cause of morbidity and mortality in pediatric patients post-hematopoietic stem cell transplantation (HSCT).
- Limited multicenter data exists on BSI incidence and risk factors in this vulnerable population.
Purpose of the Study:
- To investigate the incidence and identify risk factors for BSI in children undergoing HSCT in a multicenter setting.
- To determine if specific nonmalignant diseases are associated with increased BSI risk post-HSCT.
Main Methods:
- Retrospective cohort analysis of 277 pediatric patients undergoing allogeneic or autologous HSCT across three institutions from 1988-2009.
- Analysis focused on BSI occurring within 100 days post-HSCT.
- Multivariate analysis was employed to identify independent risk factors for BSI.
Main Results:
- BSI was observed in 24 out of 277 (8.7%) HSCT patients within the first 100 days post-transplant.
- Nonmalignant disease was identified as an independent risk factor for BSI (HR 6.3, CI 1.4-12.8, P=0.012).
- Specifically, aplastic anemia and Wiskott-Aldrich syndrome were highlighted as significant risk factors.
Conclusions:
- Aplastic anemia and Wiskott-Aldrich syndrome represent novel, significant risk factors for BSI in pediatric HSCT recipients.
- These findings underscore the importance of vigilant monitoring and tailored prophylactic strategies for children with these conditions undergoing HSCT.
Abstract:
Bloodstream infection (BSI) is a recognized cause of morbidity and mortality in children after hematopoietic stem cell transplantation (HSCT). However, there are limited reports on BSI after HSCT in pediatric patients in multiple centers. This study was a retrospective cohort analysis of consecutive patients who underwent allogeneic and autologous HSCT at the Department of Paediatrics, Hokkaido University Hospital, between 1988 and 2009; the Department of Paediatrics, Sapporo Hokuyu Hospital, between 2007 and 2009; and the Department of Paediatrics, Asahikawa Medical University, between 1989 and 2009. A total of 277 patients underwent HSCT during the study period. In this multicenter analysis, cases of BSI after HSCT were recorded in the early posttransplant period (within the first 100 d), and BSI was observed in 24 of 277 HSCT patients. Multivariate analysis showed that nonmalignant disease was an independent factor associated with BSI after HSCT (hazard ratio 6.3 for aplastic anemia or Wiskott-Aldrich syndrome patients; confidence interval, 1.4-12.8; P = 0.012). We conclude that aplastic anemia and Wiskott-Aldrich syndrome were the novel risk factors for BSI in pediatric patients after HSCT.
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