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. 2021 Jun 24;9(7):1371.
doi: 10.3390/microorganisms9071371.

An Observational Prospective Cohort Study of Incidence and Outcome of Streptococcus pneumoniae and Hemophilus influenzae Infections in Adult Solid Organ Transplant Recipients

Omid Rezahosseini  1 , Dina Leth Møller  1 , Søren Schwartz Sørensen  2   3 , Michael Perch  3   4 , Finn Gustafsson  3   5 , Marco Gelpi  1 , Jenny Knudsen  6 , Marie Helleberg  7 , Allan Rasmussen  8 , Susanne Dam Nielsen  1   3 , Zitta Barrella Harboe  1   9   10
Affiliations

An Observational Prospective Cohort Study of Incidence and Outcome of Streptococcus pneumoniae and Hemophilus influenzae Infections in Adult Solid Organ Transplant Recipients

Omid Rezahosseini et al. Microorganisms. .

Abstract

Background: Streptococcus pneumoniae (S. pneumoniae) and Hemophilus influenzae (H. influenzae) are among the main vaccine-preventable bacterial infections in immunocompromised individuals including solid organ transplant (SOT) recipients. There is a lack of information about incidence and outcomes of these infections in SOT recipients.

Methods: We determined the incidence of S. pneumoniae and H. influenzae, the related hospitalization, and 30- and 180-days mortality in a large cohort of 1182 adult SOT recipients. We calculated 95% confidence intervals (CI) of incidence rate (IR) using Byar's approximation to the Poisson distribution.

Results: The overall IR of S. pneumoniae and H. influenzae were 1086 (95% CI, 796-1448) and 1293 (95% CI, 974-1687) per 100,000 person-years of follow-up (PYFU), respectively. The IR of invasive infections were 76 (95% CI, 21-202) and 25 (95% CI, 2.3-118) per 100,000 PYFU, respectively. Hospital admission was required in >50%, 30-days mortality was 0, and 180-days mortality was 8.8% and 4.5% after S. pneumoniae and H. influenzae infections, respectively.

Conclusions: The IR of invasive S. pneumoniae and H. influenzae infections in SOT recipients were much higher than reports from the general population in Denmark. Furthermore, a large proportion of infected SOT recipients were hospitalized. These findings highlight the need for further studies to assess uptake and immunogenicity of vaccines against S. pneumoniae and H. influenzae in SOT recipients.

Keywords: Hemophilus influenzae; Streptococcus pneumoniae; hospitalization; incidence; invasive pneumococcal diseases; mortality; organ transplant.

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Conflict of interest statement

O.R. received a grant from The Research Foundation of Rigshospitalet; S.S.S. reported other non-financial relations with Alexion, Hansa Biopharma, and Corline Biomedical, outside the submitted work; M.P. received a grant from Roche, non-financial support from Boehringer Ingelheim, personal fees from Mallinckrodt, Novartis, GSK, and Astra-Zeneca not related to this work; F.G. received personal fees from Abbott, Novartis, Boehringer-Ingelheim, Orion Pharma, Pfizer, and AstraZeneca and had other financial relationship with Corvia not related to this work; M.G. received a grant from Augustinus Foundation not related to this work; S.D.N. received unrestricted research grants from Novo Nordisk Foundation and Independent Research Fund (FSS); D.L.M., J.K., M.H., A.R. and Z.B.H. declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Cumulative incidence of the first episode of S. pneumoniae and H. influenzae infections during the five years post-transplantation. (A) Cumulative incidence (3.9% (95% CI, 0.63–7.2)) of the first episode of S. pneumoniae infection. There was no statistically significant difference in cumulative incidence of the first episode of S. pneumoniae infection between different types of transplanted organs (p = 0.82). (B) Cumulative incidence (5.0% (95% CI, 1.8–8.1)) of the first episode of H. influenzae infection. There was no statistically significant difference in cumulative incidence of the first episode of H. influenzae infection between different types of transplanted organs (p = 0.57). Simultaneous kidney and pancreas transplant recipients had no episode of H. influenzae infection. Black continuous line shows the cumulative incidence of the first episode of infection in the total cohort of solid organ transplant (SOT) recipients. Colorful dashed lines indicate cumulative incidence of the first episode of infection according to the type of transplanted organ. Vertical dotted-lines determine 30 days (brown), 6 months (red), 1 year (yellow), and 5 years (blue) post-transplantation.
Figure 1
Figure 1
Cumulative incidence of the first episode of S. pneumoniae and H. influenzae infections during the five years post-transplantation. (A) Cumulative incidence (3.9% (95% CI, 0.63–7.2)) of the first episode of S. pneumoniae infection. There was no statistically significant difference in cumulative incidence of the first episode of S. pneumoniae infection between different types of transplanted organs (p = 0.82). (B) Cumulative incidence (5.0% (95% CI, 1.8–8.1)) of the first episode of H. influenzae infection. There was no statistically significant difference in cumulative incidence of the first episode of H. influenzae infection between different types of transplanted organs (p = 0.57). Simultaneous kidney and pancreas transplant recipients had no episode of H. influenzae infection. Black continuous line shows the cumulative incidence of the first episode of infection in the total cohort of solid organ transplant (SOT) recipients. Colorful dashed lines indicate cumulative incidence of the first episode of infection according to the type of transplanted organ. Vertical dotted-lines determine 30 days (brown), 6 months (red), 1 year (yellow), and 5 years (blue) post-transplantation.
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References

    1. Van Delden C., Stampf S., Hirsch H.H., Manuel O., Meylan P., Cusini A., Hirzel C., Khanna N., Weisser M., Garzoni C., et al. Burden and timeline of infectious diseases in the first year after solid organ transplantation in the swiss transplant cohort study. Clin. Infect. Dis. 2020;71:e159–e169. doi: 10.1093/cid/ciz1113. - DOI - PMC - PubMed
    1. Fishman J.A. Infection in Organ Transplantation. Am. J. Transplant. 2017;17:856–879. doi: 10.1111/ajt.14208. - DOI - PubMed
    1. Singh N., Haidar G., Limaye A.P. Infections in Solid-Organ Transplant Recipients. In: Bennett M.D., Dolin J.E., Blaser R., editors. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Elsevier; Hoboken, NJ, USA: 2020. pp. 3672–3697.e4.
    1. Danziger-Isakov L., Kumar D. Vaccination of solid organ transplant candidates and recipients: Guidelines from the American society of transplantation infectious diseases community of practice. Clin. Transplant. 2019;33:e13563. doi: 10.1111/ctr.13563. - DOI - PubMed
    1. Dendle C., Stuart R.L., Mulley W.R., Holdsworth S.R. Pneumococcal vaccination in adult solid organ transplant recipients: A review of current evidence. Vaccine. 2018;36:6253–6261. doi: 10.1016/j.vaccine.2018.08.069. - DOI - PubMed

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