Staphylococcus aureus infections among children receiving a solid organ transplant: clinical features, epidemiology, and antimicrobial susceptibility
Background Staphylococcus aureus is among the most common causes of healthcare‐associated infection (HAI) in the United States. Patients who have received a solid organ transplant (SOT) represent a unique population for the acquisition of HAIs, given their preoperative organ failure, immunosuppressi...
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| Veröffentlicht in: | Transplant infectious disease 2015-02, Vol.17 (1), p.39-47 |
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| creator | McNeil, J.C. Munoz, F.M. Hultén, K.G. Mason, E.O. Kaplan, S.L. |
| description | Background
Staphylococcus aureus is among the most common causes of healthcare‐associated infection (HAI) in the United States. Patients who have received a solid organ transplant (SOT) represent a unique population for the acquisition of HAIs, given their preoperative organ failure, immunosuppression, and need for invasive procedures. However, limited literature is published on S. aureus infections among children with SOT. We describe the epidemiology, antimicrobial susceptibility, and clinical features of S. aureus infections among pediatric SOT recipients.
Design
An ongoing prospective S. aureus surveillance database from 2001 to 2012 was searched for infections in patients with a history of SOT at Texas Children's Hospital. Medical records and antibiotic susceptibility profiles were reviewed; specific attention was applied to the time since transplantation to infection.
Results
Out of the total of 696 transplants performed during the study period, 38 pediatric SOT recipients developed 41 S. aureus infections; the highest incidence of infection was among heart recipients. Overall, the most common infectious diagnoses were skin‐and‐soft‐tissue infections (66.1%), followed by bacteremia (15.3%). Among isolates in SOT patients, 47.5%, 16.9%, and 6.7% were resistant to methicillin, clindamycin, or mupirocin, respectively. Three infections (7.3%) occurred in the early post‐transplant period (6 months). In 10 cases (16.9%), S. aureus infection was associated with graft rejection during the same admission.
Conclusions
S. aureus represents an important cause of morbidity in pediatric SOT recipients. While the majority of infections occurred late after transplant (>6 months), those acquired in the early post‐transplant period were more often invasive and caused by MSSA in our hospital. Physicians caring for SOT recipients should be aware of the risks posed by this pathogen and the potential concomitant morbidity including graft rejection. |
| doi_str_mv | 10.1111/tid.12331 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4308533</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3567312321</sourcerecordid><originalsourceid>FETCH-LOGICAL-i4771-a821e54d4384cda01a1aa08f41fdcb81203de0107733b865e5baad3376888e213</originalsourceid><addsrcrecordid>eNpdUk1v1DAQjRAVLYUDfwBF4sKhae04Hw4HJFSgrbSABKXlZjm2d3eKYwfbKeSH8H8ZdssKsDSa0cybp3njybInlBxTfCcJ9DEtGaP3sgPKuq5gpCnvb2JelGXL9rOHMd4QQtuu6h5k-2Vdt6xsuoPs56ckx_VsvfJKTTGXUzDowC2NSuAdZgbvVrlag9XBuDwYZeAWMCXz6C3o3IeVdHkK0sXRSpde5MqCAyVtvjQyIWE8ys0I2gzgrV_NR7l0Gi3BACr4HhAZp6jMmKAHC2l-lO0tpY3m8Z0_zD6_fXN5el4sPpxdnL5aFFC1LS0kL6mpK10xXiktCZVUSsKXFV1q1XNaEqYNoaRtGet5U5u6l1Iz1jacc1NSdpi93PKOUz8YrYxDGVaMAQYZZuEliH8rDtZi5W9FxQivGUOC53cEwX-bTExiABRicQ_GT1HQpi4r3HrTIvTZf9AbPwWH8hCFcnjTUI6op39PtBvlz48h4GQL-A7WzLs6JeL3KQg8BbE5BXF58XoTYEex7YCYzI9dhwxfBY7V1uL6_Zmg182XxcerK_GO_QK-ErnM</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1647786618</pqid></control><display><type>article</type><title>Staphylococcus aureus infections among children receiving a solid organ transplant: clinical features, epidemiology, and antimicrobial susceptibility</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>McNeil, J.C. ; Munoz, F.M. ; Hultén, K.G. ; Mason, E.O. ; Kaplan, S.L.</creator><creatorcontrib>McNeil, J.C. ; Munoz, F.M. ; Hultén, K.G. ; Mason, E.O. ; Kaplan, S.L.</creatorcontrib><description>Background
Staphylococcus aureus is among the most common causes of healthcare‐associated infection (HAI) in the United States. Patients who have received a solid organ transplant (SOT) represent a unique population for the acquisition of HAIs, given their preoperative organ failure, immunosuppression, and need for invasive procedures. However, limited literature is published on S. aureus infections among children with SOT. We describe the epidemiology, antimicrobial susceptibility, and clinical features of S. aureus infections among pediatric SOT recipients.
Design
An ongoing prospective S. aureus surveillance database from 2001 to 2012 was searched for infections in patients with a history of SOT at Texas Children's Hospital. Medical records and antibiotic susceptibility profiles were reviewed; specific attention was applied to the time since transplantation to infection.
Results
Out of the total of 696 transplants performed during the study period, 38 pediatric SOT recipients developed 41 S. aureus infections; the highest incidence of infection was among heart recipients. Overall, the most common infectious diagnoses were skin‐and‐soft‐tissue infections (66.1%), followed by bacteremia (15.3%). Among isolates in SOT patients, 47.5%, 16.9%, and 6.7% were resistant to methicillin, clindamycin, or mupirocin, respectively. Three infections (7.3%) occurred in the early post‐transplant period (<1 month), all of which were bacteremia (P = 0.007) and all caused by methicillin‐susceptible S. aureus (MSSA). The majority of infections (90.2%) occurred in the late post‐transplant period (>6 months). In 10 cases (16.9%), S. aureus infection was associated with graft rejection during the same admission.
Conclusions
S. aureus represents an important cause of morbidity in pediatric SOT recipients. While the majority of infections occurred late after transplant (>6 months), those acquired in the early post‐transplant period were more often invasive and caused by MSSA in our hospital. Physicians caring for SOT recipients should be aware of the risks posed by this pathogen and the potential concomitant morbidity including graft rejection.</description><identifier>ISSN: 1398-2273</identifier><identifier>EISSN: 1399-3062</identifier><identifier>DOI: 10.1111/tid.12331</identifier><identifier>PMID: 25573269</identifier><language>eng</language><publisher>Denmark: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Anti-Infective Agents - therapeutic use ; Bacteremia ; Child ; Cross Infection ; Female ; Humans ; Incidence ; Male ; Organ Transplantation - adverse effects ; pediatric ; Prospective Studies ; Soft Tissue Infections - drug therapy ; Soft Tissue Infections - epidemiology ; Staphylococcal Infections - drug therapy ; Staphylococcal Infections - epidemiology ; Staphylococcus aureus ; Staphylococcus aureus - drug effects ; Staphylococcus aureus - isolation & purification ; transplant ; United States - epidemiology</subject><ispartof>Transplant infectious disease, 2015-02, Vol.17 (1), p.39-47</ispartof><rights>2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><rights>2015 Wiley Periodicals, Inc</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftid.12331$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftid.12331$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,315,781,785,886,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25573269$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McNeil, J.C.</creatorcontrib><creatorcontrib>Munoz, F.M.</creatorcontrib><creatorcontrib>Hultén, K.G.</creatorcontrib><creatorcontrib>Mason, E.O.</creatorcontrib><creatorcontrib>Kaplan, S.L.</creatorcontrib><title>Staphylococcus aureus infections among children receiving a solid organ transplant: clinical features, epidemiology, and antimicrobial susceptibility</title><title>Transplant infectious disease</title><addtitle>Transpl Infect Dis</addtitle><description>Background
Staphylococcus aureus is among the most common causes of healthcare‐associated infection (HAI) in the United States. Patients who have received a solid organ transplant (SOT) represent a unique population for the acquisition of HAIs, given their preoperative organ failure, immunosuppression, and need for invasive procedures. However, limited literature is published on S. aureus infections among children with SOT. We describe the epidemiology, antimicrobial susceptibility, and clinical features of S. aureus infections among pediatric SOT recipients.
Design
An ongoing prospective S. aureus surveillance database from 2001 to 2012 was searched for infections in patients with a history of SOT at Texas Children's Hospital. Medical records and antibiotic susceptibility profiles were reviewed; specific attention was applied to the time since transplantation to infection.
Results
Out of the total of 696 transplants performed during the study period, 38 pediatric SOT recipients developed 41 S. aureus infections; the highest incidence of infection was among heart recipients. Overall, the most common infectious diagnoses were skin‐and‐soft‐tissue infections (66.1%), followed by bacteremia (15.3%). Among isolates in SOT patients, 47.5%, 16.9%, and 6.7% were resistant to methicillin, clindamycin, or mupirocin, respectively. Three infections (7.3%) occurred in the early post‐transplant period (<1 month), all of which were bacteremia (P = 0.007) and all caused by methicillin‐susceptible S. aureus (MSSA). The majority of infections (90.2%) occurred in the late post‐transplant period (>6 months). In 10 cases (16.9%), S. aureus infection was associated with graft rejection during the same admission.
Conclusions
S. aureus represents an important cause of morbidity in pediatric SOT recipients. While the majority of infections occurred late after transplant (>6 months), those acquired in the early post‐transplant period were more often invasive and caused by MSSA in our hospital. Physicians caring for SOT recipients should be aware of the risks posed by this pathogen and the potential concomitant morbidity including graft rejection.</description><subject>Adolescent</subject><subject>Anti-Infective Agents - therapeutic use</subject><subject>Bacteremia</subject><subject>Child</subject><subject>Cross Infection</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Organ Transplantation - adverse effects</subject><subject>pediatric</subject><subject>Prospective Studies</subject><subject>Soft Tissue Infections - drug therapy</subject><subject>Soft Tissue Infections - epidemiology</subject><subject>Staphylococcal Infections - drug therapy</subject><subject>Staphylococcal Infections - epidemiology</subject><subject>Staphylococcus aureus</subject><subject>Staphylococcus aureus - drug effects</subject><subject>Staphylococcus aureus - isolation & purification</subject><subject>transplant</subject><subject>United States - epidemiology</subject><issn>1398-2273</issn><issn>1399-3062</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUk1v1DAQjRAVLYUDfwBF4sKhae04Hw4HJFSgrbSABKXlZjm2d3eKYwfbKeSH8H8ZdssKsDSa0cybp3njybInlBxTfCcJ9DEtGaP3sgPKuq5gpCnvb2JelGXL9rOHMd4QQtuu6h5k-2Vdt6xsuoPs56ckx_VsvfJKTTGXUzDowC2NSuAdZgbvVrlag9XBuDwYZeAWMCXz6C3o3IeVdHkK0sXRSpde5MqCAyVtvjQyIWE8ys0I2gzgrV_NR7l0Gi3BACr4HhAZp6jMmKAHC2l-lO0tpY3m8Z0_zD6_fXN5el4sPpxdnL5aFFC1LS0kL6mpK10xXiktCZVUSsKXFV1q1XNaEqYNoaRtGet5U5u6l1Iz1jacc1NSdpi93PKOUz8YrYxDGVaMAQYZZuEliH8rDtZi5W9FxQivGUOC53cEwX-bTExiABRicQ_GT1HQpi4r3HrTIvTZf9AbPwWH8hCFcnjTUI6op39PtBvlz48h4GQL-A7WzLs6JeL3KQg8BbE5BXF58XoTYEex7YCYzI9dhwxfBY7V1uL6_Zmg182XxcerK_GO_QK-ErnM</recordid><startdate>201502</startdate><enddate>201502</enddate><creator>McNeil, J.C.</creator><creator>Munoz, F.M.</creator><creator>Hultén, K.G.</creator><creator>Mason, E.O.</creator><creator>Kaplan, S.L.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QO</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201502</creationdate><title>Staphylococcus aureus infections among children receiving a solid organ transplant: clinical features, epidemiology, and antimicrobial susceptibility</title><author>McNeil, J.C. ; Munoz, F.M. ; Hultén, K.G. ; Mason, E.O. ; Kaplan, S.L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-i4771-a821e54d4384cda01a1aa08f41fdcb81203de0107733b865e5baad3376888e213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Anti-Infective Agents - therapeutic use</topic><topic>Bacteremia</topic><topic>Child</topic><topic>Cross Infection</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Organ Transplantation - adverse effects</topic><topic>pediatric</topic><topic>Prospective Studies</topic><topic>Soft Tissue Infections - drug therapy</topic><topic>Soft Tissue Infections - epidemiology</topic><topic>Staphylococcal Infections - drug therapy</topic><topic>Staphylococcal Infections - epidemiology</topic><topic>Staphylococcus aureus</topic><topic>Staphylococcus aureus - drug effects</topic><topic>Staphylococcus aureus - isolation & purification</topic><topic>transplant</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McNeil, J.C.</creatorcontrib><creatorcontrib>Munoz, F.M.</creatorcontrib><creatorcontrib>Hultén, K.G.</creatorcontrib><creatorcontrib>Mason, E.O.</creatorcontrib><creatorcontrib>Kaplan, S.L.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Biotechnology Research Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Transplant infectious disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McNeil, J.C.</au><au>Munoz, F.M.</au><au>Hultén, K.G.</au><au>Mason, E.O.</au><au>Kaplan, S.L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Staphylococcus aureus infections among children receiving a solid organ transplant: clinical features, epidemiology, and antimicrobial susceptibility</atitle><jtitle>Transplant infectious disease</jtitle><addtitle>Transpl Infect Dis</addtitle><date>2015-02</date><risdate>2015</risdate><volume>17</volume><issue>1</issue><spage>39</spage><epage>47</epage><pages>39-47</pages><issn>1398-2273</issn><eissn>1399-3062</eissn><abstract>Background
Staphylococcus aureus is among the most common causes of healthcare‐associated infection (HAI) in the United States. Patients who have received a solid organ transplant (SOT) represent a unique population for the acquisition of HAIs, given their preoperative organ failure, immunosuppression, and need for invasive procedures. However, limited literature is published on S. aureus infections among children with SOT. We describe the epidemiology, antimicrobial susceptibility, and clinical features of S. aureus infections among pediatric SOT recipients.
Design
An ongoing prospective S. aureus surveillance database from 2001 to 2012 was searched for infections in patients with a history of SOT at Texas Children's Hospital. Medical records and antibiotic susceptibility profiles were reviewed; specific attention was applied to the time since transplantation to infection.
Results
Out of the total of 696 transplants performed during the study period, 38 pediatric SOT recipients developed 41 S. aureus infections; the highest incidence of infection was among heart recipients. Overall, the most common infectious diagnoses were skin‐and‐soft‐tissue infections (66.1%), followed by bacteremia (15.3%). Among isolates in SOT patients, 47.5%, 16.9%, and 6.7% were resistant to methicillin, clindamycin, or mupirocin, respectively. Three infections (7.3%) occurred in the early post‐transplant period (<1 month), all of which were bacteremia (P = 0.007) and all caused by methicillin‐susceptible S. aureus (MSSA). The majority of infections (90.2%) occurred in the late post‐transplant period (>6 months). In 10 cases (16.9%), S. aureus infection was associated with graft rejection during the same admission.
Conclusions
S. aureus represents an important cause of morbidity in pediatric SOT recipients. While the majority of infections occurred late after transplant (>6 months), those acquired in the early post‐transplant period were more often invasive and caused by MSSA in our hospital. Physicians caring for SOT recipients should be aware of the risks posed by this pathogen and the potential concomitant morbidity including graft rejection.</abstract><cop>Denmark</cop><pub>Blackwell Publishing Ltd</pub><pmid>25573269</pmid><doi>10.1111/tid.12331</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Transplant infectious disease, 2015-02, Vol.17 (1), p.39-47 |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Adolescent Anti-Infective Agents - therapeutic use Bacteremia Child Cross Infection Female Humans Incidence Male Organ Transplantation - adverse effects pediatric Prospective Studies Soft Tissue Infections - drug therapy Soft Tissue Infections - epidemiology Staphylococcal Infections - drug therapy Staphylococcal Infections - epidemiology Staphylococcus aureus Staphylococcus aureus - drug effects Staphylococcus aureus - isolation & purification transplant United States - epidemiology |
| title | Staphylococcus aureus infections among children receiving a solid organ transplant: clinical features, epidemiology, and antimicrobial susceptibility |
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