Clostridium difficile infection after pediatric solid organ transplantation: a practical single-center experience.
Adolescent
Anti-Bacterial Agents
/ adverse effects
Child
Child, Preschool
Clostridioides difficile
Enterocolitis, Pseudomembranous
/ etiology
Female
Humans
Immunosuppression Therapy
/ adverse effects
Infant
Infant, Newborn
Kidney Transplantation
/ adverse effects
Liver Transplantation
/ adverse effects
Male
Recurrence
Retrospective Studies
Risk Factors
Young Adult
Children
Clostridium difficile infection
Immunosuppression
Solid organ transplantation
Journal
Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
received:
30
09
2018
accepted:
14
02
2019
revised:
06
02
2019
pubmed:
8
3
2019
medline:
3
6
2020
entrez:
8
3
2019
Statut:
ppublish
Résumé
During the last two decades, there has been a worldwide increase in frequency and severity of infections with Clostridium difficile (CDI). Solid organ transplant (SOT) recipients receiving immunosuppressing medications are especially at risk. We collected data from immunocompromised pediatric patients, including kidney and liver transplant recipients, at our tertiary pediatric care center in Germany. For this, we performed a retrospective review of institutional databases and analyzed data from all children who underwent diagnostic tests for CDI in a 3-year study period. A total of 797 diagnostic tests in 343 patients were performed. We found 104 infection episodes in 69 patients (42% female, ages 12 days-20 years). Children after SOT accounted for 20% of all detected CDI patients in our series. Median time of CDI onset after transplantation was 588 days. Overall antibiotic exposure was identified as the major risk factor, particularly in immunocompromised children after SOT (exposure in > 95% of all cases). The occurrence of CDI in the pediatric SOT population contributes to a greater length of stay and higher hospital charges. However, only very few severe complications from CDI were observed in our cohort. A potentially fulminant course of CDI can be prevented in most cases if timely diagnosis and treatment are carried out.
Sections du résumé
BACKGROUND
During the last two decades, there has been a worldwide increase in frequency and severity of infections with Clostridium difficile (CDI). Solid organ transplant (SOT) recipients receiving immunosuppressing medications are especially at risk.
METHODS
We collected data from immunocompromised pediatric patients, including kidney and liver transplant recipients, at our tertiary pediatric care center in Germany. For this, we performed a retrospective review of institutional databases and analyzed data from all children who underwent diagnostic tests for CDI in a 3-year study period.
RESULTS
A total of 797 diagnostic tests in 343 patients were performed. We found 104 infection episodes in 69 patients (42% female, ages 12 days-20 years). Children after SOT accounted for 20% of all detected CDI patients in our series. Median time of CDI onset after transplantation was 588 days. Overall antibiotic exposure was identified as the major risk factor, particularly in immunocompromised children after SOT (exposure in > 95% of all cases).
CONCLUSIONS
The occurrence of CDI in the pediatric SOT population contributes to a greater length of stay and higher hospital charges. However, only very few severe complications from CDI were observed in our cohort. A potentially fulminant course of CDI can be prevented in most cases if timely diagnosis and treatment are carried out.
Identifiants
pubmed: 30843115
doi: 10.1007/s00467-019-04219-5
pii: 10.1007/s00467-019-04219-5
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1269-1275Références
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