Bacterial and fungal bloodstream infections in pediatric liver and kidney transplant recipients
Abstract Background Bacterial 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...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-06-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-021-06224-2 |
| _version_ | 1819007023371517952 |
|---|---|
| author | Dina Leth Møller Søren Schwartz Sørensen Neval Ete Wareham Omid Rezahosseini Andreas Dehlbæk Knudsen Jenny Dahl Knudsen Allan Rasmussen Susanne Dam Nielsen |
| author_facet | Dina Leth Møller Søren Schwartz Sørensen Neval Ete Wareham Omid Rezahosseini Andreas Dehlbæk Knudsen Jenny Dahl Knudsen Allan Rasmussen Susanne Dam Nielsen |
| author_sort | Dina Leth Møller |
| collection | DOAJ |
| description | Abstract Background Bacterial 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. Methods A 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. Results A 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. Conclusions BSI 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. |
| first_indexed | 2024-12-21T00:17:59Z |
| format | Article |
| id | doaj.art-8ae4ebfc92a440658f79629090360ef8 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-21T00:17:59Z |
| publishDate | 2021-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-8ae4ebfc92a440658f79629090360ef82022-12-21T19:22:10ZengBMCBMC Infectious Diseases1471-23342021-06-012111910.1186/s12879-021-06224-2Bacterial and fungal bloodstream infections in pediatric liver and kidney transplant recipientsDina Leth Møller0Søren Schwartz Sørensen1Neval Ete Wareham2Omid Rezahosseini3Andreas Dehlbæk Knudsen4Jenny Dahl Knudsen5Allan Rasmussen6Susanne Dam Nielsen7Viro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of CopenhagenDepartment of Nephrology, Rigshospitalet, University of CopenhagenCentre of Excellence for Health, Immunity, and Infections, Department of Infectious Diseases, Rigshospitalet, University of CopenhagenViro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of CopenhagenViro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of CopenhagenDepartment of Clinical Microbiology, Rigshospitalet, University of CopenhagenDepartment of Surgical Gastroenterology and Transplantation, Rigshospitalet, University of CopenhagenViro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of CopenhagenAbstract Background Bacterial 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. Methods A 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. Results A 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. Conclusions BSI 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.https://doi.org/10.1186/s12879-021-06224-2Liver transplantationKidney transplantationBacteremiaFungemia |
| spellingShingle | Dina Leth Møller Søren Schwartz Sørensen Neval Ete Wareham Omid Rezahosseini Andreas Dehlbæk Knudsen Jenny Dahl Knudsen Allan Rasmussen Susanne Dam Nielsen Bacterial and fungal bloodstream infections in pediatric liver and kidney transplant recipients BMC Infectious Diseases Liver transplantation Kidney transplantation Bacteremia Fungemia |
| title | Bacterial and fungal bloodstream infections in pediatric liver and kidney transplant recipients |
| title_full | Bacterial and fungal bloodstream infections in pediatric liver and kidney transplant recipients |
| title_fullStr | Bacterial and fungal bloodstream infections in pediatric liver and kidney transplant recipients |
| title_full_unstemmed | Bacterial and fungal bloodstream infections in pediatric liver and kidney transplant recipients |
| title_short | Bacterial and fungal bloodstream infections in pediatric liver and kidney transplant recipients |
| title_sort | bacterial and fungal bloodstream infections in pediatric liver and kidney transplant recipients |
| topic | Liver transplantation Kidney transplantation Bacteremia Fungemia |
| url | https://doi.org/10.1186/s12879-021-06224-2 |
| work_keys_str_mv | AT dinalethmøller bacterialandfungalbloodstreaminfectionsinpediatricliverandkidneytransplantrecipients AT sørenschwartzsørensen bacterialandfungalbloodstreaminfectionsinpediatricliverandkidneytransplantrecipients AT nevaletewareham bacterialandfungalbloodstreaminfectionsinpediatricliverandkidneytransplantrecipients AT omidrezahosseini bacterialandfungalbloodstreaminfectionsinpediatricliverandkidneytransplantrecipients AT andreasdehlbækknudsen bacterialandfungalbloodstreaminfectionsinpediatricliverandkidneytransplantrecipients AT jennydahlknudsen bacterialandfungalbloodstreaminfectionsinpediatricliverandkidneytransplantrecipients AT allanrasmussen bacterialandfungalbloodstreaminfectionsinpediatricliverandkidneytransplantrecipients AT susannedamnielsen bacterialandfungalbloodstreaminfectionsinpediatricliverandkidneytransplantrecipients |