Adderson Elisabeth E, Boudreaux Jan W, Hayden Randall T
Department of Infectious Diseases, St. Jude Children's Research Hospital, Department of Molecular Sciences, University of Tennessee Health Sciences Center, Memphis, TN 38105, USA.
Pediatr Infect Dis J. 2008 Feb;27(2):136-41. doi: 10.1097/INF.0b013e31814fab12.
Invasive infections caused by coryneform bacteria are uncommon but have been reported with increasing frequency in recent decades, especially in immunocompromised persons. Because pediatric experience is limited, we examined the epidemiology and clinical characteristics of these infections in children undergoing cancer therapy.
Using strict case definitions, 17 coryneform bacterial infections were identified in 16 children during a 13-year period; there were 12 episodes of bacteremia and 5 skin or soft tissue infections.
The median age of children with bloodstream infections was 11.2 years, and that of children with skin or soft tissue infections was 3.5 years. Most were receiving cancer therapy at the time of their infections, were outpatients at the onset of their infections, had central venous catheters, and were not neutropenic. No patient died as a result of infection and most had relatively mild signs and symptoms. All patients responded promptly to antimicrobial therapy and, although 3 infections relapsed, there was only 1 serious complication. The most common species isolated were Corynebacterium striatum, C. amycolatum, and Microbacterium species.
The epidemiologic and clinical features of coryneform bacterial infections in immunocompromised children differ in several important respects from the previously reported characteristics of these infections in adults.
棒状杆菌引起的侵袭性感染并不常见，但近几十年来报告的频率有所增加，尤其是在免疫功能低下的人群中。由于儿科方面的经验有限，我们研究了接受癌症治疗的儿童中这些感染的流行病学和临床特征。
采用严格的病例定义，在13年期间，16名儿童中确诊了17例棒状杆菌感染；其中有12例菌血症发作和5例皮肤或软组织感染。
发生血流感染的儿童中位年龄为11.2岁，发生皮肤或软组织感染的儿童中位年龄为3.5岁。大多数患儿在感染时正在接受癌症治疗，感染开始时为门诊患者，有中心静脉导管，且无中性粒细胞减少症。没有患者因感染死亡，大多数患者的体征和症状相对较轻。所有患者对抗菌治疗反应迅速，虽然有3例感染复发，但只有1例严重并发症。分离出的最常见菌种为纹带棒状杆菌、无糖棒状杆菌和微杆菌属。
免疫功能低下儿童中棒状杆菌感染的流行病学和临床特征在几个重要方面与先前报道的成人这些感染的特征有所不同。
