Details

Autor(en) / Beteiligte

• Kumar, D.
• Humar, A.
• Plevneshi, A.
• Green, K.
• Prasad, G.V.R.
• Siegal, D.
• McGeer, A.

Titel

Invasive Pneumococcal Disease in Solid Organ Transplant Recipients—10‐Year Prospective Population Surveillance

Ist Teil von

• American journal of transplantation, 2007-05, Vol.7 (5), p.1209-1214

Ort / Verlag

Oxford, UK: Blackwell Publishing Ltd

Erscheinungsjahr

2007

Quelle

MEDLINE

Beschreibungen/Notizen

• Prospective population‐based surveillance to assess the incidence and impact of invasive pneumococcal disease (IPD) in organ transplant patients is lacking. By using a population‐based Invasive Bacterial Diseases Network surveillance program, we studied the incidence, clinical significance, serotypes and antimicrobial resistance pattern of IPD in a large cohort of adult transplant patients and the general population. Streptococcus pneumoniae isolates and patient data were collected prospectively from 1995 to 2004. We identified 21 cases of IPD (based on sterile‐site isolates) in our organ transplant population over a 10‐year period. This translated to an incidence rate of 146 infections per 100 000 persons per year. This compared to an incidence of 11.5 per 100 000 persons per year in the general population (RR= 12.8; 95% CI 8.1–19.9, p < 0.00001). If nonsterile‐site isolates (respiratory tract) were included, the incidence rate in transplant patients was 419 of 100 000 persons per year. Serotypes 23F and 22F were most common, and 85.0% had a serotype included in the 23‐valent pneumococcal vaccine. The antimicrobial resistance rates were high, especially for penicillin and trimethoprim‐sulfamethoxazole (TMP/SMX), but were not significantly different from the general population. Solid organ transplant recipients are at significantly greater risk for IPD than the general population. Preventative strategies are necessary. Comparison of an organ transplant population to the general population showed that transplant patients had more than ten times higher risk of invasive pneumococcal disease compared to the general population.