S taphylococcus aureus infections among children receiving a solid organ transplant: clinical features, epidemiology, and antimicrobial susceptibility

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 HAI s, given their preoperative organ failure, i...

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Bibliographic Details
Published in:Transplant infectious disease 2015-02, Vol.17 (1), p.39-47
Main Authors: McNeil, J.C., Munoz, F.M., Hultén, K.G., Mason, E.O., Kaplan, S.L.
Format: Article
Language:English
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Summary: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 HAI s, 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. aur eus 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.
ISSN:1398-2273
1399-3062
DOI:10.1111/tid.12331