Affordable Access

Access to the full text

Bacterial and fungal bloodstream infections in pediatric liver and kidney transplant recipients

Authors
  • Møller, Dina Leth1
  • Sørensen, Søren Schwartz2, 2
  • Wareham, Neval Ete2
  • Rezahosseini, Omid1
  • Knudsen, Andreas Dehlbæk1, 2
  • Knudsen, Jenny Dahl2
  • Rasmussen, Allan2
  • Nielsen, Susanne Dam1, 2
  • 1 University of Copenhagen, Blegdamsvej 9B, Copenhagen Ø, DK-2100, Denmark , Copenhagen Ø (Denmark)
  • 2 University of Copenhagen, Copenhagen, Denmark , Copenhagen (Denmark)
Type
Published Article
Journal
BMC Infectious Diseases
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Jun 08, 2021
Volume
21
Issue
1
Identifiers
DOI: 10.1186/s12879-021-06224-2
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundBacterial and fungal bloodstream infections (BSI) are common after pediatric liver and kidney transplantations and associated with morbidity and mortality. However, knowledge about incidence rates, pathogen composition, and resistance patterns is limited. We aimed to describe the pattern of bacterial and fungal BSI in a cohort of pediatric liver and kidney transplant recipients.MethodsA prospective study of 85 pediatric liver and kidney transplant recipients transplanted from 2010 to 2017 with a total of 390 person-years of follow-up. Clinical characteristics and BSI were retrieved from national registries assuring nationwide follow-up for at least 1 year. BSI incidence rates and pathogen composition were investigated and stratified by the time post-transplantation and type of transplanted organ.ResultsA total of 29 BSI were observed within the first 5 years post-transplantation with 16 different pathogens. The overall incidence rate of first BSI was 1.91 per 100 recipients per month (95% CI, 1.1–3.1) in the first year post-transplantation. The most common pathogens were Enterococcus faecium, Candida albicans, Escherichia coli, and Klebsiella pneumoniae. The pathogen composition depended on the transplanted organ with a higher proportion of BSI with Enterobacterales in kidney transplant recipients than in liver transplant recipients (67% vs. 20%, p = 0.03), while multiple pathogens were detected in the liver transplant recipients.ConclusionsBSI were common in pediatric liver and kidney transplant recipients and the pathogen composition differed between liver and kidney transplant recipients. Guidelines for empiric antibiotic therapy should consider the type of transplanted organ as well as the local resistance patterns.

Report this publication

Statistics

Seen <100 times