Multidrug-resistant bacterial infections in children undergoing hematopoietic stem cell transplantation over a 6-year period: analysis of the of Polish Pediatric Group for Hematopoietic Stem Cell Transplantation
AIMS: Multidrug-resistant (MDR) bacteria are an emerging cause of morbidity and mortality after hematopoietic stem cell transplantation (HSCT). The aim of the study was to analyze the incidence, clinical characteristics and survival from bacterial infections caused by MDR pathogens in pediatric HSCT recipients. METHODS AND RESULTS Between 2012 and 2017, among 971 transplanted patients, bacterial infections were found in 416
children. Overall, there were 883 bacterial episodes, including 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 bacterial infections between allo- and auto-HSCT recipients. However, survival in MDR and non-MDR infections was comparable. SIGNIFICANCE AND IMPACT OF STUDY The large sample size enables unique analysis and makes our data more applicable to other pediatric HSCT centers. In case of the absence of local epidemiological data, presented clinical characteristic of MDR-caused infections may be used to optimize the prophylactic strategies, early identification of infectious complications of MDR etiology, and thus promptly initiate adequate antibiotic therapy and further improve patients' outcome.