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

Anna Jabłońska^{1

2}, Monika Richert-Przygońska², Kamila Jaremek², Krzysztof Czyżewski^{2

3}, Wanda Badowska⁴, Walentyna Balwierz⁵, Ewa Bień⁶, Tomasz Brzeski⁴, Radosław Chaber⁷, Wojciech Czogała⁵, Bożenna Dembowska-Bagińska⁸, Katarzyna Derwich³, Katarzyna Drabko⁹, Katarzyna Dzierżanowska-Fangrat¹⁰, Jowita Frączkiewicz¹¹, Agnieszka Gietka⁸, Jolanta Goździk¹², Olga Gryniewicz-Kwiatkowska⁸, Łukasz Hutnik¹³, Ninela Irga-Jaworska⁶, Krzysztof Kałwak¹¹, Grażyna Karolczyk¹⁴, Aleksandra Królak¹⁵, Pawel Łaguna¹³, Katarzyna Machnik¹⁶, Hanna Mańko-Glińska⁴, Agnieszka Mizia-Malarz¹⁷, Wojciech Młynarski¹⁸, Jakub Musiał⁷, Katarzyna Mycko⁴, Tomasz Ociepa¹⁵, Sonia Pająk¹⁶, Jarosław Peregud-Pogorzelski¹⁹, Filip Pierlejewski¹⁸, Marcin Płonowski²⁰, Małgorzata Salamonowicz-Bodzioch¹¹, Małgorzata Sawicka-Żukowska²⁰, Katarzyna Semczuk¹⁰, Katarzyna Skowron-Kandzia¹⁷, Weronika Stolpa¹⁷, Tomasz Szczepański²¹, Anna Szmydki-Baran¹³, Renata Tomaszewska²¹, Tomasz Urasiński¹⁵, Agnieszka Urbanek-Dądela¹⁴, Justyna Urbańska-Rakus¹⁶, Paweł Wawryków¹⁹, Olga Zając-Spychała³, Patrycja Zalas-Więcek²², Agnieszka Zaucha-Prażmo⁹, Joanna Zawitkowska⁹, Iwona Żak²³, Jan Styczyński²

Affiliations

¹ Doctoral School of Medical and Health Sciences, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, 85-067 Bydgoszcz, Poland.
² Department of Paediatric Haematology and Oncology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland.
³ Department of Paediatric Oncology, Haematology and Transplantology, University of Medical Sciences, 61-701 Poznan, Poland.
⁴ Department of Clinical Paediatrics, University of Warmia and Mazury, Clinical Division of Paediatric Oncology and Haematology, Regional Specialised Children's Hospital, 10-561 Olsztyn, Poland.
⁵ Department of Paediatric Oncology and Haematology, Institute of Paediatrics, Jagiellonian University Medical College, 31-008 Krakow, Poland.
⁶ Department of Paediatrics, Haematology and Oncology, Medical University, 80-210 Gdansk, Poland.
⁷ Department of Paediatric Oncohaematology, Medical Faculty University of Rzeszow, Clinical Provincial Hospital No. 2, 35-301 Rzeszow, Poland.
⁸ Department of Oncology, Children's Memorial Health Institute, 04-730 Warsaw, Poland.
⁹ Department of Paediatric Haematology, Oncology and Transplantology, Medical University of Lublin, 20-059 Lublin, Poland.
¹⁰ Department of Clinical Microbiology and Immunology, Children's Memorial Health Institute, 04-730 Warsaw, Poland.
¹¹ Department of Paediatric Haematology, Oncology and BMT, Wroclaw Medical University, 50-367 Wrocław, Poland.
¹² Stem Cell Transplant Center, University Children's Hospital, Department of Clinical Immunology and Transplantology, Jagiellonian University Collegium Medicum, 31-008 Krakow, Poland.
¹³ Department of Oncology, Paediatric Haematology, Clinical Transplantation and Paediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland.
¹⁴ Division of Paediatric Haematology and Oncology, Children Hospital, 25-736 Kielce, Poland.
¹⁵ Department of Paediatrics and Haemato-Oncology, Pomeranian Medical University, 70-204 Szczecin, Poland.
¹⁶ Division of Paediatric Haematology and Oncology, Chorzow City Hospital, 41-500 Chorzow, Poland.
¹⁷ Division of Paediatric Oncology, Haematology and Chemotherapy, Department of Paediatrics, Silesian Medical University, 40-055 Katowice, Poland.
¹⁸ Department of Paediatrics, Haematology and Oncology, Medical University, 90-419 Lodz, Poland.
¹⁹ Department of Paediatrics, Paediatric Oncology and Immunology, Pomeranian Medical University, 70-204 Szczecin, Poland.
²⁰ Department of Paediatric Oncology and Haematology, Medical University, 15-089 Bialystok, Poland.
²¹ Department of Paediatric Haematology and Oncology, Silesian Medical University, 41-808 Zabrze, Poland.
²² Microbiology Department, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland.
²³ Department of Microbiology, University Children's Hospital, 30-663 Krakow, Poland.

PMID: 40806822
PMCID: PMC12346928
DOI: 10.3390/jcm14155200

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

Anna Jabłońska et al. J Clin Med. 2025.

. 2025 Jul 22;14(15):5200.

doi: 10.3390/jcm14155200.

Authors

Affiliations

¹ Doctoral School of Medical and Health Sciences, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, 85-067 Bydgoszcz, Poland.
² Department of Paediatric Haematology and Oncology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland.
³ Department of Paediatric Oncology, Haematology and Transplantology, University of Medical Sciences, 61-701 Poznan, Poland.
⁴ Department of Clinical Paediatrics, University of Warmia and Mazury, Clinical Division of Paediatric Oncology and Haematology, Regional Specialised Children's Hospital, 10-561 Olsztyn, Poland.
⁵ Department of Paediatric Oncology and Haematology, Institute of Paediatrics, Jagiellonian University Medical College, 31-008 Krakow, Poland.
⁶ Department of Paediatrics, Haematology and Oncology, Medical University, 80-210 Gdansk, Poland.
⁷ Department of Paediatric Oncohaematology, Medical Faculty University of Rzeszow, Clinical Provincial Hospital No. 2, 35-301 Rzeszow, Poland.
⁸ Department of Oncology, Children's Memorial Health Institute, 04-730 Warsaw, Poland.
⁹ Department of Paediatric Haematology, Oncology and Transplantology, Medical University of Lublin, 20-059 Lublin, Poland.
¹⁰ Department of Clinical Microbiology and Immunology, Children's Memorial Health Institute, 04-730 Warsaw, Poland.
¹¹ Department of Paediatric Haematology, Oncology and BMT, Wroclaw Medical University, 50-367 Wrocław, Poland.
¹² Stem Cell Transplant Center, University Children's Hospital, Department of Clinical Immunology and Transplantology, Jagiellonian University Collegium Medicum, 31-008 Krakow, Poland.
¹³ Department of Oncology, Paediatric Haematology, Clinical Transplantation and Paediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland.
¹⁴ Division of Paediatric Haematology and Oncology, Children Hospital, 25-736 Kielce, Poland.
¹⁵ Department of Paediatrics and Haemato-Oncology, Pomeranian Medical University, 70-204 Szczecin, Poland.
¹⁶ Division of Paediatric Haematology and Oncology, Chorzow City Hospital, 41-500 Chorzow, Poland.
¹⁷ Division of Paediatric Oncology, Haematology and Chemotherapy, Department of Paediatrics, Silesian Medical University, 40-055 Katowice, Poland.
¹⁸ Department of Paediatrics, Haematology and Oncology, Medical University, 90-419 Lodz, Poland.
¹⁹ Department of Paediatrics, Paediatric Oncology and Immunology, Pomeranian Medical University, 70-204 Szczecin, Poland.
²⁰ Department of Paediatric Oncology and Haematology, Medical University, 15-089 Bialystok, Poland.
²¹ Department of Paediatric Haematology and Oncology, Silesian Medical University, 41-808 Zabrze, Poland.
²² Microbiology Department, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland.
²³ Department of Microbiology, University Children's Hospital, 30-663 Krakow, Poland.

PMID: 40806822
PMCID: PMC12346928
DOI: 10.3390/jcm14155200

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**
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**
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.

See this image and copyright information in PMC

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Grants and funding

LinkOut - more resources

Full Text Sources

Miscellaneous