Pneumococcal infections in children after transplantation

Area of Science:

• Pediatric Infectious Diseases
• Transplant Immunology
• Microbiology

Background:

• Bacterial infections, particularly Streptococcus pneumoniae, are significant causes of morbidity and mortality in pediatric transplant recipients.
• Patients undergoing bone marrow and solid-organ transplantation are at increased risk due to immunosuppression.

Purpose of the Study:

• To review the characteristics and outcomes of Streptococcus pneumoniae infections in pediatric transplant recipients.
• To assess the impact of immunosuppressive and antimicrobial therapies on infection risk.
• To evaluate antimicrobial susceptibilities and vaccine uptake in this vulnerable population.

Main Methods:

• Retrospective review of 42 pediatric patients who underwent transplantation and developed Streptococcus pneumoniae infection.
• Analysis of patient demographics, infection episodes, therapies, vaccination status, and isolate antimicrobial susceptibilities.

Main Results:

• Solid-organ transplant recipients were more prone to recurrent invasive disease (P<.02).
• 74% of patients were on immunosuppressive therapy, and 74% had recent antimicrobial exposure.
• Only 33% of eligible patients received pneumococcal vaccination; 26% of isolates were penicillin-nonsusceptible, and 18% were ceftriaxone-nonsusceptible.
• Two infection-related deaths occurred, one with a penicillin-nonsusceptible isolate.

Conclusions:

• Infections with Streptococcus pneumoniae in pediatric transplant recipients share similar antimicrobial susceptibilities and outcomes compared to the general pediatric population.
• Recurrent invasive disease is more common in solid-organ transplant recipients.
• Vaccination rates and antimicrobial resistance patterns warrant attention in this immunocompromised group.