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. 2025 Jul 22;14(15):5200.
doi: 10.3390/jcm14155200.

Infections with Staphylococcus spp. in Children Undergoing Anticancer Therapy or Haematopoietic Cell Transplantation: A Nationwide Multicentre Study

Anna Jabłońska  1   2 , Monika Richert-Przygońska  2 , Kamila Jaremek  2 , Krzysztof Czyżewski  2   3 , Wanda Badowska  4 , Walentyna Balwierz  5 , Ewa Bień  6 , Tomasz Brzeski  4 , Radosław Chaber  7 , Wojciech Czogała  5 , Bożenna Dembowska-Bagińska  8 , Katarzyna Derwich  3 , Katarzyna Drabko  9 , Katarzyna Dzierżanowska-Fangrat  10 , Jowita Frączkiewicz  11 , Agnieszka Gietka  8 , Jolanta Goździk  12 , Olga Gryniewicz-Kwiatkowska  8 , Łukasz Hutnik  13 , Ninela Irga-Jaworska  6 , Krzysztof Kałwak  11 , Grażyna Karolczyk  14 , Aleksandra Królak  15 , Pawel Łaguna  13 , Katarzyna Machnik  16 , Hanna Mańko-Glińska  4 , Agnieszka Mizia-Malarz  17 , Wojciech Młynarski  18 , Jakub Musiał  7 , Katarzyna Mycko  4 , Tomasz Ociepa  15 , Sonia Pająk  16 , Jarosław Peregud-Pogorzelski  19 , Filip Pierlejewski  18 , Marcin Płonowski  20 , Małgorzata Salamonowicz-Bodzioch  11 , Małgorzata Sawicka-Żukowska  20 , Katarzyna Semczuk  10 , Katarzyna Skowron-Kandzia  17 , Weronika Stolpa  17 , Tomasz Szczepański  21 , Anna Szmydki-Baran  13 , Renata Tomaszewska  21 , Tomasz Urasiński  15 , Agnieszka Urbanek-Dądela  14 , Justyna Urbańska-Rakus  16 , Paweł Wawryków  19 , Olga Zając-Spychała  3 , Patrycja Zalas-Więcek  22 , Agnieszka Zaucha-Prażmo  9 , Joanna Zawitkowska  9 , Iwona Żak  23 , Jan Styczyński  2
Affiliations

Infections with Staphylococcus spp. in Children Undergoing Anticancer Therapy or Haematopoietic Cell Transplantation: A Nationwide Multicentre Study

Anna Jabłońska et al. J Clin Med. .

Abstract

Background: Staphylococcus spp. represent the most prevalent Gram-positive organisms in children with malignancies or undergoing haematopoietic cell transplantation (HCT), contributing to significant morbidity and mortality. This study aimed to assess the epidemiology, risk factors, treatment strategies, and outcomes of staphylococcal infections (SIs) in paediatric haemato-oncology (PHO) and HCT patients in Poland over a 12-year period. Methods: A retrospective, multicentre study was conducted across 17 paediatric oncology centres in Poland. The clinical and microbiological data of patients under the age of 18, diagnosed with malignancies or post-HCT, were analysed for confirmed SI between 2012 and 2023. The variables assessed included demographics, underlying conditions, infection type and source, antimicrobial susceptibility, treatment, and 30-day infection-free survival. Results: Among 1725 patients with SI, 1433 were PHO and 292 were HCT patients. The cumulative incidence of SI was 12.7% in PHO and 14.3% in HCT patients (p = 0.008). The 30-day survival rate was significantly higher in PHO compared to HCT patients (98.4% vs. 93.2%, p < 0.001). Most deaths were caused by S. epidermidis, S. haemolyticus, and S. hominis, predominantly involving methicillin-resistant coagulase-negative Staphylococci (MRCNS). Multivariate Cox regression identified undergoing HCT (HR = 3.0, 95% CI: 1.6-5.6, p < 0.001) and treatment of infection > 10 days (HR = 2.0, 95% CI: 1.1-3.6, p = 0.019) as independent risk factors for mortality. Conclusions: Staphylococcal infections pose a significant challenge in paediatric oncology and transplant populations. Optimising prevention, diagnostics, and antimicrobial therapy is crucial for improving outcomes in these high-risk groups.

Keywords: Staphylococcus; bacteraemia; haematopoietic cell transplantation; infection; leukaemia; oncology; paediatric malignancy.

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Conflict of interest statement

The authors have no conflict of interest to disclose.

Figures

Figure 1
Figure 1
Cumulative incidence of infections with Staphylococcus spp. in HCT and PHO patients, with respect to the most common primary diseases and two-year time intervals. (a) Total, PHO vs. HCT; (b) ALL, PHO vs. HCT; (c) AML, PHO vs. HCT; (d) MDS, PHO vs. HCT; (e) NBL, PHO vs. HCT; (f) NHL, PHO vs. HCT; (g) PHO, 2012–2013 vs. 2014–2015 vs. 2016–2017; (h) PHO, 2018–2019 vs. 2020–2021 vs. 2022–2023; (i) HCT, 2012–2013 vs. 2014–2015 vs. 2016–2017; (j) HCT 2018–2019 vs. 2020–2021 vs. 2022–2023.
Figure 2
Figure 2
Survival from staphylococcal infection in PHO and HCT settings, with respect to the most common primary diseases and two-year time intervals. (a) Total, PHO vs. HCT; (b) ALL, PHO vs. HCT; (c) AML, PHO vs. HCT; (d) MDS, PHO vs. HCT; (e) PHO, 2012–2013 vs. 2014–2015 vs. 2016–2017; (f) PHO, 2018–2019 vs. 2020–2021 vs. 2022–2023; (g) HCT, 2012–2013 vs. 2014–2015 vs. 2016–2017; (h) HCT 2018–2019 vs. 2020–2021 vs. 2022–2023.
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