Infectious complications in the pediatric immunocompromised host: a narrative review.

Diagnostics Guidelines Infection Secondary immunodeficiency antimicrobial compounds primary immunodeficiency

Journal

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420

Informations de publication

Date de publication:
06 Jun 2024
Historique:
received: 20 01 2024
revised: 30 05 2024
accepted: 01 06 2024
medline: 9 6 2024
pubmed: 9 6 2024
entrez: 8 6 2024
Statut: aheadofprint

Résumé

Infections are a major cause for morbidity in children with primary or secondary immunodeficiency, and have a negative impact on overall outcome. This narrative review presents select pediatric specific aspects regarding the clinical impact, diagnosis, management and follow-up of infectious complications in patients with primary and secondary immunodeficiencies. PubMed until January 2024 and searched references in identified articles including the search terms: infection, immunodeficiency or cancer, diagnostics, antimicrobial agents, bacteria or fungus or virus, and follow-up. Major advances have been made in the early detection and management of patients with primary immunodeficiency, and multiple analyses report in children with cancer on risk groups and periods of risk for infectious complications. Although many diagnostic tools are comparable between children and adults, specific considerations have to be applied, such as minimizing the use of radiation. Antimicrobial drug development remains a major challenge in the pediatric setting, which includes the establishment of appropriate dosing and pediatric approval. Last, long-term follow-up and the impact of late effects are extremely important to be considered in the management of immunocompromised pediatric patients. Although infectious disease supportive care of immunocompromised children and adolescents has considerably improved over the last three decades, close international collaboration is needed to target the specific challenges in this special population.

Sections du résumé

BACKGROUND BACKGROUND
Infections are a major cause for morbidity in children with primary or secondary immunodeficiency, and have a negative impact on overall outcome.
OBJECTIVES OBJECTIVE
This narrative review presents select pediatric specific aspects regarding the clinical impact, diagnosis, management and follow-up of infectious complications in patients with primary and secondary immunodeficiencies.
SOURCES METHODS
PubMed until January 2024 and searched references in identified articles including the search terms: infection, immunodeficiency or cancer, diagnostics, antimicrobial agents, bacteria or fungus or virus, and follow-up.
CONTENT BACKGROUND
Major advances have been made in the early detection and management of patients with primary immunodeficiency, and multiple analyses report in children with cancer on risk groups and periods of risk for infectious complications. Although many diagnostic tools are comparable between children and adults, specific considerations have to be applied, such as minimizing the use of radiation. Antimicrobial drug development remains a major challenge in the pediatric setting, which includes the establishment of appropriate dosing and pediatric approval. Last, long-term follow-up and the impact of late effects are extremely important to be considered in the management of immunocompromised pediatric patients.
IMPLICATIONS CONCLUSIONS
Although infectious disease supportive care of immunocompromised children and adolescents has considerably improved over the last three decades, close international collaboration is needed to target the specific challenges in this special population.

Identifiants

pubmed: 38851426
pii: S1198-743X(24)00279-9
doi: 10.1016/j.cmi.2024.06.002
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Conflicts of interest TL received a research grant from Gilead Sciences, and served as a consultant to Gilead Sciences, Pfizer, Merck/MSD, Mundipharma, Roche, Recordati and Pharming, and in the speaker’s bureau of Gilead Sciences, Merck/MSD, AstraZeneca, Recordati, Pfizer, and Sanofi Pasteur. AHG received a research grant from Gilead Sciences, and served as a consultant to Mundipharma, Pfizer, AstraZeneca and Scynexis and in the speaker’s bureau of Astellas and AstraZeneca. Both authors contributed to the conceptualization and writing (both first draft and editing) of the review. Both authors have read the final version and approved it.

Auteurs

Thomas Lehrnbecher (T)

Department of Pediatrics, Division of Hematology, Oncology and Hemostaseology, Goethe University Frankfurt, Frankfurt am Main, Germany. Electronic address: Thomas_Lehrnbecher@yahoo.com.

Andreas H Groll (AH)

Infectious Disease Research Program, Center for Bone Marrow Transplantation and Department of Pediatric Hematology/Oncology, University Children's Hospital Muenster, Muenster, Germany.

Classifications MeSH