Landa Mario M, Rosenthal Ayelet, Li Caitlin Naureckas, Arshad Mehreen, Patel Sameer, Kociolek Larry, Barnes Alyah, Karuri Stella, Muller William J
Division of Infectious Diseases, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Transpl Infect Dis. 2025 Apr 21;27(4):e70030. doi: 10.1111/tid.70030.
Bacteremia is a major cause of morbidity and mortality in immunocompromised children, yet there are limited data in children who have undergone solid organ transplantation (SOT).
We retrospectively reviewed bloodstream infections (BSI) in 581 recipients of heart, liver, or kidney transplants over a 14-year period.
Overall 1-year incidence in this population was 8.4%, and was highest in recipients of liver transplants compared to heart or kidney. Younger age, transplantation earlier in the time period studied, need for repeat surgery within 30 days of transplant, and prior diagnosis of diabetes or tumor were associated with an increased risk of BSI. Most BSI occurred within 90 days of transplant, and most were associated with central venous lines. Coagulase-negative staphylococci and enteric commensals were commonly isolated. Multiple BSI within the year after transplant were uncommon. Although overall mortality was not increased in patients with BSI compared to those without, patients with BSI had more total hospitalizations and more days spent in the hospital in the year following SOT.
In a large pediatric SOT population, overall BSI rates were significant but decreased over time. Identifying factors which contribute to BSI after SOT may direct interventions that can impact inpatient care requirements for these patients.
菌血症是免疫功能低下儿童发病和死亡的主要原因，但实体器官移植（SOT）儿童的数据有限。
我们回顾性分析了581例心脏、肝脏或肾脏移植受者在14年期间的血流感染（BSI）情况。
该人群的总体1年发病率为8.4%，与心脏或肾脏移植受者相比，肝脏移植受者的发病率最高。年龄较小、在研究时间段内较早进行移植、移植后30天内需要再次手术以及先前诊断为糖尿病或肿瘤与BSI风险增加相关。大多数BSI发生在移植后90天内，且大多数与中心静脉导管相关。凝固酶阴性葡萄球菌和肠道共生菌是常见的分离菌。移植后一年内多次发生BSI并不常见。尽管与无BSI的患者相比，BSI患者的总体死亡率没有增加，但BSI患者在SOT后的一年中住院总次数更多，住院天数更长。
在一大群儿科SOT人群中，总体BSI发生率较高，但随时间推移有所下降。确定SOT后导致BSI的因素可能指导干预措施，从而影响这些患者的住院护理需求。
