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Research Article
Susanne Nielsen
Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen
Corresponding Author
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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 one 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.
Keywords
Liver transplantation, kidney transplantation, bacteremia, fungemia.
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CURRENT STATUS: Under Review
Version 1
Posted 14 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 22 Mar, 2021
Reviewers agreed
On 25 Feb, 2021
Reviews received
Received 26 Dec, 2020
Reviewers agreed
On 15 Dec, 2020
Reviewers invited
Invitations sent on 14 Dec, 2020
Editor assigned
On 14 Dec, 2020
Editor invited
On 11 Dec, 2020
Submission checks complete
On 11 Dec, 2020
First submitted
On 26 Nov, 2020
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Subject Areas
Infectious Diseases
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This preprint is under consideration at BMC Infectious Diseases. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Susanne Nielsen
Viro-immunology Research Unit, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 14 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 22 Mar, 2021
Reviewers agreed
On 25 Feb, 2021
Reviews received
Received 26 Dec, 2020
Reviewers agreed
On 15 Dec, 2020
Reviewers invited
Invitations sent on 14 Dec, 2020
Editor assigned
On 14 Dec, 2020
Editor invited
On 11 Dec, 2020
Submission checks complete
On 11 Dec, 2020
First submitted
On 26 Nov, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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 one 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.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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