Bacteremia in Pediatric Solid Organ Transplant Recipients within 1 Year of Transplant

Background: Bacteremia is a major cause of morbidity and mortality in immunocompromised children, yet there are limited data in children who have undergone solid organ transplantation (SOT). Methods: We retrospectively reviewed bloodstream infections (BSI) in 581 recipients of heart, liver, or kidney transplants over a 14-year period. Results: Overall 1-year incidence in this population was 8.4%, and was highest in recipients of liver transplants compared to heart or kidney. Younger age, transplantation earlier in the time period studied, need for repeat surgery within 30 days of transplant, and prior diagnosis of diabetes or tumor were associated with an increased risk of BSI. Most BSI occurred within 90 days of transplant, and most were associated with central venous lines. Coagulase-negative staphylococci and enteric commensals were commonly isolated. Multiple BSI within the year after transplant were uncommon. Although overall mortality was not increased in patients with BSI compared to those without, patients with BSI had more total hospitalizations and more days spent in the hospital in the year following SOT. Conclusion: In a large pediatric SOT population, overall BSI rates were significant but decreased over time. Identifying factors which contribute to BSI after SOT may direct interventions that can impact inpatient care requirements for these patients. (Figure presented.).