A SINGLE CENTRE RETROSPECTIVE 5 YEAR SURVEY OF INFECTIOUS COMPLICATION IN 85 CHILDREN WITH COMBINED IMMUNODEFICIENCY

Abstract

Children with primary Tslymphocyte deficiency arc more ."I/."'clptihfe to infection hy organisms such (15: bacteria, fungi. prolo:o(J lind virus, 1711.' isniatian oj all opponuniuic ory;ani."m or an IImallally severe infection with higher grade pathogens, provide a clue (0 diagnosis of immunodeficiency, To determine the microorganisms causing recurrent or severe infections in children with T•(rmpllOcy!e doflcicncy, we carried out II retrospective case review oj H5 patients with 1'../ympllOC)'te deficiency who wuc investigated at the Great Ormond Street Hospital for Children, NHS Trust, OH'r the 5 year period between June I, 11)88 and June I, 11)93. Tuc /:mllp of patients included 53 mules anti 32 [cmales, among which 23 and 62 were diagnosed to prewnt SClf) (/",1 elf) subtypes respectively, Among the 174 organisms isolated. these included bacteria (97 isolates], viruses (43 isolates}, funJ:i (25 isolates] and parasites (9 isolates}, 17lC predominant ."ites of infections were mainly the gll."trointe."titwl (60 out of 174) and respiratory tracts (49 out of 174). 171£' most common bacterial infections, were with aerobic gram negative organisms (28 isolatcs), P.H'UdOmOnllS aeruginosa (17 isolates], Enterococcus (/2 isolates), C. difficile (10 isolates], Analysis: of 43 viral infection showed that Homvirus (10 isolates], Adenovirus (9 isolates], Herpes simplex (6 isolates], am!
C}loml'!:altH'iTlH (6 isalatcs), Wi'rl! prrdominutu pathogens. Candida albicans was IIII' most commonly isolated fungi. Parasitic infections included P. curini and Cryp(o."poridillm, 3 and (j opt of 9 cases. In our }iTOUp of pmients 16 patients' died before hone maTOOW transplantation, due to infectimu complication. Based on this ."tlldy. we ,wgge.lt thai pronytaxis aJjllin.rt bacterial, viral, Jllngal ami protozoa agents is a necessity to minimize infectious complication." in 7~/ympilOcyte deficient patients, awaiting a hone marrow transplantation.