Invasive fungal infections in the pediatric hematopoietic stem cell transplant recipient

Over a ten year period; January 1, 1992 to December 31, 2001, 168 pediatric patients had 174 hematopoietic stem cell transplant (HSCT) procedures in Calgary, Canada. Eighteen definite invasive fungal infections (IFI) (6 proven and 12 probable) were found: 103.4 cases per 1000 HSCT admissions; incidence rate 10.3%. No seasonality was found. Risk factors for developing IFI were: CMV reactivation, increased number of days in hospital, of total parenteral nutrition, neutropenia, fever, and broad spectrum antibiotics (graft versus host disease and age < 8 years approached statistical significance). Patients with IFI had statistically increased mortality at 1 year and multiple morbidities (mortality at 30 days approached statistical significance).