Clostridium difficile infection after pediatric solid organ transplantation: a practical single-center experience
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Clostridium difficile infection after pediatric solid organ transplantation: a practical single-center experience. / Breuer, Christian; Döring, Sabrina; Rohde, Holger; Rutkowski, Stefan; Müller, Ingo; Oh, Jun.
in: PEDIATR NEPHROL, Jahrgang 34, Nr. 7, 07.2019, S. 1269-1275.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Clostridium difficile infection after pediatric solid organ transplantation: a practical single-center experience
AU - Breuer, Christian
AU - Döring, Sabrina
AU - Rohde, Holger
AU - Rutkowski, Stefan
AU - Müller, Ingo
AU - Oh, Jun
PY - 2019/7
Y1 - 2019/7
N2 - 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.
AB - 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.
KW - Journal Article
U2 - 10.1007/s00467-019-04219-5
DO - 10.1007/s00467-019-04219-5
M3 - SCORING: Journal article
C2 - 30843115
VL - 34
SP - 1269
EP - 1275
JO - PEDIATR NEPHROL
JF - PEDIATR NEPHROL
SN - 0931-041X
IS - 7
ER -