Incidence of bacteremias and invasive mycoses in children undergoing allogeneic hematopoietic stem cell transplantation: a single center experience

We performed a retrospective single center study to de. ne 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.