Pneumococcal infections in children after transplantation.
Bacterial infections in recipients of bone marrow and solid-organ transplants remain a major cause of morbidity and death. The cases of 42 children who had undergone transplantation and developed an infection with Streptococcus pneumoniae were retrospectively reviewed. Thirty-four patients had 1 episode of infection, whereas 7 had 2 episodes and 1 had 3 episodes of infection. Solid-organ recipients were more likely to have recurrent invasive disease (P<.02). A total of 31 (74%) of 42 patients were on immunosuppressive therapy, and 74% had been on antimicrobial therapy within 30 days before diagnosis of S. pneumoniae infection. Only 33% of eligible patients had received a pneumococcal vaccine. Twenty-six percent of isolates recovered were not susceptible to penicillin, and 18% were not susceptible to ceftriaxone. Two patients experienced infection-related deaths; one of these had a penicillin-nonsusceptible isolate. The antimicrobial susceptibilities and outcome of infections with S. pneumoniae in patients who have undergone transplantation are similar to those in the general pediatric population.
Schutze
G E
GE
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA. schutzegordone@exchange.uams.edu
Mason
E O
EO
Wald
E R
ER
Barson
W J
WJ
Bradley
J S
JS
Tan
T Q
TQ
Kim
K S
KS
Givner
L B
LB
Yogev
R
R
Kaplan
S L
SL
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D016377:Organ Transplantation / Q000009:adverse effects*; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents