1132. Pneumocystis infection in children: National trends and characteristics in the United States, 1997-2012
Session: Poster Abstract Session: Fungi and Parasites in Immunocompromised Patients
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • Poster_IDWeek_2018.png (3.1 MB)
  • Background:

    Although epidemiology of immunocompromising condition in children has evolved over time, updated epidemiology of pediatric pneumocystis infection in the US is not available.

    Methods:

    We performed a retrospective analysis using the Kids’ Inpatient Database, a nationally representative sample of US pediatric hospital discharges collected in 1997, 2000, 2003, 2006, 2009, and 2012. Pneumocystis cases were identified using International

    Classification of Diseases, Ninth Revision, Clinical Modification code 136.3 among children aged 0-18 years. Demographic data of cases with and without mortality were compared. 

    Results:

    We identified 1,902 (standard error, SE: 95) pneumocystis cases during the study period. The pneumocystis hospitalization rate decreased from 7.5 (SE: 0.91) to 2.7 (SE: 0.31) per a million US children from 1997 to 2012 (63.2% decrease). Cases with human immunodeficiency virus (HIV) infection decreased from 285 (SE: 56) cases in 1997 to 29 (SE: 7) cases in 2012, although non-HIV-associated cases remained relatively stable. After 2009, HIV was the third common underlying disorder after hematologic malignancy and primary immunodeficiency. All-cause in-hospital mortality was 11.7% (SE: 1.3%) and was particularly high among cases with hematopoietic stem cell transplant (HSCT) (32.4% [SE: 7.1%]) (p <0.001).

    Conclusion:

    Pneumocystis infection in children showed a marked decrease from 1997 to 2012 in the US, largely driven by the reduction in HIV-associated cases. Non-HIV illnesses including hematologic malignancy and primary immunodeficiency became prominent underlying conditions over time. HSCT-associated cases had particularly high mortality. Non-HIV conditions should be the target for primary and secondary prevention in reducing the disease burden.

     

    Kengo Inagaki, MD, University of Mississippi Medical Center, Jackson, MS, Chad Blackshear, MS, Data Science, University of Mississippi Medical Center, Jackson, MS and Charlotte V. Hobbs, MD, Pediatrics, University of Mississippi Medical Center, Jackson, MS

    Disclosures:

    K. Inagaki, None

    C. Blackshear, None

    C. V. Hobbs, None

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