Invasive fungal infections in pediatric hematopoietic stem cell transplant patients

Tiffany Simms-Waldrip, Galit Rosen, Karin Nielsen-Saines, Alan Ikeda, Berkley Brown, Theodore Moore

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Background: Pediatric hematopoietic stem cell transplant (HSCT) recipients are at high risk of invasive fungal infections (IFIs). Methods: To characterize IFIs and changes in fungal organisms over time in pediatric HSCT patients, we performed a retrospective cohort study of all HSCTs performed in pediatric patients at UCLA between 1991 and 2006. Results: In all, 318 patients underwent 324 HSCT transplants over the 15-year period and 69 unique fungal infections were identified in 47 transplant patients. The overall incidence of fungal infections in HSCT recipients was 14.5%, with predominant organisms including Candida species (51%) and Aspergillus species (26%), with Candida albicans accounting for 18.8% of all fungal species. The distribution of organisms over time demonstrated a strong trend towards an increase in rare molds in more recent years. The respiratory tract was the main site of infection (52.6%), with urine and blood also noted as significant sites. Of all deaths in the patients with IFIs, fungal-related mortality accounted for 67.6% of deaths. Conclusions: HSCT patients have a much higher risk of fungal infections with rarer organisms becoming more prevalent, a finding likely linked to evolving antifungal practices over time. This emphasizes the need for the development and implementation of improved diagnostic, prophylactic, and therapeutic strategies to improve patient survival.

Original languageEnglish (US)
Pages (from-to)218-224
Number of pages7
JournalInfectious Diseases
Volume47
Issue number4
DOIs
StatePublished - 2015

Keywords

  • Aspergillus
  • Candida
  • Fungal infections
  • HSCT
  • Pediatric
  • Stem cell transplant

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Medicine(all)

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