Infectious complications after hematopoietic stem cell transplantation for primary immunodeficiency in children: A multicenter nationwide study.

Autor: Zając-Spychała O; Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland., Zaucha-Prażmo A; Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical University, Lublin, Poland., Zawitkowska J; Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical University, Lublin, Poland., Wachowiak J; Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland., Kowalczyk JR; Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical University, Lublin, Poland., Frączkiewicz J; Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland., Salamonowicz M; Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland., Kałwak K; Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland., Gorczyńska E; Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland., Chybicka A; Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland., Czyżewski K; Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland., Dziedzic M; Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland., Wysocki M; Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland., Zalas-Więcek P; Department of Microbiology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland., Goździk J; Stem Cell Transplant Center, Department of Clinical Immunology and Transplantology, Jagiellonian University Collegium Medicum, University Children's Hospital, Krakow, Poland., Styczyński J; Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
Jazyk: angličtina
Zdroj: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology [Pediatr Allergy Immunol] 2020 Jul; Vol. 31 (5), pp. 537-543. Date of Electronic Publication: 2020 Apr 06.
DOI: 10.1111/pai.13239
Abstrakt: Purpose: The aim of this nationwide study was to evaluate the characteristics of bacterial infections (BI), invasive fungal disease (IFD), and viral infections (VI) in pediatric patients with PID after allogeneic hematopoietic stem cell transplantation (allo-HSCT).
Patients and Methods: In total, 114 HSCT recipients were enrolled into the study. At least one infectious complication (IC) was diagnosed in 60 (52.6%) patients aged 0.1-17.7 years, that is, 59.5% with SCID and 49.4% with non-SCID.
Results: Among 60 HSCT recipients diagnosed with at least one IC, 188 episodes of infectious complications (EIC) were recorded, that is, 46.8% of BI, 41.5% of VI, and 11.7% of proven/probable IFD. According to PID and HSCT donor type, the incidence of EIC was comparable (P = .679). The localization of infections differed significantly due to PID type (P = .002). After each HSCT donor type, the most common site of infection was GI. Overall, BI caused by Gram-positive strains (59.1%) were prevalent, especially Staphylococcaceae. The multidrug-resistant (MDR) pathogens were diagnosed in 52.3%, especially ESBL + Enterobacteriaceae. The profile of VI was comparable for SCID and non-SCID patients (P = .839). The incidence of IFD was comparable for each PID and HSCT donor type. Survival after infection was 91.5% and was comparable for PID and HSCT donor type.
Conclusions: The rate of patients diagnosed with IC among pediatric PID-HSCT recipients did not depend on PID type, but rather on HSCT donor type. The localization of IC depended on PID and HSCT donor type. Within bacterial infections, predominated Gram-positive strains and the MDR pathogens were responsible for more than half of EIC.
(© 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.)
Databáze: MEDLINE
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