Multidrug‐resistant bacterial infections in children undergoing haematopoietic stem cell transplantation over a 6‐year period: analysis of the Polish Pediatric Group for Hematopoietic Stem Cell Transplantation

Aims Multidrug‐resistant (MDR) bacteria are an emerging cause of morbidity and mortality after haematopoietic stem cell transplantation (HSCT). The aim of the study was to analyse the incidence, clinical characteristics and survival from bacterial infections (BI) caused by MDR pathogens in paediatric HSCT recipients. Methods and Results Among 971 transplanted patients, BI were found in 416 children between the years 2012 and 2017. Overall, there were 883 bacterial episodes, which includes 85·8% after allo‐HSCT and 14·2% after auto‐HSCT. MDR strains were responsible for half of the total number of bacterial episodes. Over 50% of MDR pathogens were Enterobacteriaceae causing mainly gut infections or urinary tract infections. Conclusions Regarding HSCT type, we did not find differences in the profile of MDR BI between allo‐ and auto‐HSCT recipients. However, survival in MDR and non‐MDR infections was comparable. Significance and Impact of the Study The large sample size enables unique analysis and makes our data more applicable to other paediatric HSCT centres. In the absence of local epidemiological data, presented clinical characteristics of MDR‐caused infections may be used to optimize the prophylactic strategies, early identification of infectious complications of MDR aetiology and thus promptly initiate adequate antibiotic therapy and further improve patients’ outcome.