儿童化疗和造血干细胞移植后耐多药铜绿假单胞菌感染。
Multidrug resistant Pseudomonas aeruginosa infection in children undergoing chemotherapy and hematopoietic stem cell transplantation.
机构信息
U.O. Cure Domiciliari - Terapia Cellulare, Dipartimento di Oncoematologia, Azienda Ospedaliero-Universitaria Meyer, Viale Pieraccini, 24 50139 Firenze, Italy.
出版信息
Haematologica. 2010 Sep;95(9):1612-5. doi: 10.3324/haematol.2009.020867. Epub 2010 Mar 19.
Abstract
Pseudomonas aeruginosa is one leading gram-negative organism associated with nosocomial infections. Bacteremia is life-threatening in the immunocompromised host. Increasing frequency of multi-drug-resistant (MDRPA) strains is concerning. We started a retrospective survey in the pediatric hematology oncology Italian network. Between 2000 and 2008, 127 patients with Pseudomonas aeruginosa bacteremia were reported from 12 centers; 31.4% of isolates were MDRPA. Death within 30 days of a positive blood culture occurred in 19.6% (25/127) of total patients; in patients with MDRPA infection it occurred in 35.8% (14/39). In the multivariate analysis, only MDRPA had significant association with infection-related death. This is the largest series of Pseudomonas aeruginosa bacteremia cases from pediatric hematology oncology centers. Monitoring local bacterial isolates epidemiology is mandatory and will allow empiric antibiotic therapy to be tailored to reduce fatalities.
摘要
铜绿假单胞菌是一种与医院感染相关的主要革兰氏阴性菌。菌血症在免疫功能低下的宿主中是危及生命的。日益增多的多药耐药（MDRPA）菌株令人担忧。我们在意大利儿科血液肿瘤网络中开展了一项回顾性调查。2000 年至 2008 年间，12 个中心报告了 127 例铜绿假单胞菌菌血症患者；其中 31.4%的分离株为 MDRPA。总患者中，30 天内阳性血培养相关死亡的发生率为 19.6%（25/127）；在 MDRPA 感染者中，死亡率为 35.8%（14/39）。多变量分析显示，只有 MDRPA 与感染相关死亡有显著相关性。这是来自儿科血液肿瘤中心的最大系列铜绿假单胞菌菌血症病例。监测当地细菌分离株的流行病学是强制性的，这将有助于调整经验性抗生素治疗，以降低死亡率。
相似文献
1
Multidrug resistant Pseudomonas aeruginosa infection in children undergoing chemotherapy and hematopoietic stem cell transplantation.
Haematologica. 2010 Sep;95(9):1612-5. doi: 10.3324/haematol.2009.020867. Epub 2010 Mar 19.
2
Control of Multidrug-Resistant Pseudomonas aeruginosa in Allogeneic Hematopoietic Stem Cell Transplant Recipients by a Novel Bundle Including Remodeling of Sanitary and Water Supply Systems.
Clin Infect Dis. 2017 Sep 15;65(6):935-942. doi: 10.1093/cid/cix465.
3
Pseudomonas aeruginosa bacteremia in children: analysis of trends in prevalence, antibiotic resistance and prognostic factors.
Pediatr Infect Dis J. 2000 Oct;19(10):959-63. doi: 10.1097/00006454-200010000-00003.
4
Nosocomial infections due to multidrug-resistant Pseudomonas aeruginosa: epidemiology and treatment options.
Pharmacotherapy. 2005 Oct;25(10):1353-64. doi: 10.1592/phco.2005.25.10.1353.
5
Fecal colonization and infection with Pseudomonas aeruginosa in recipients of allogeneic hematopoietic stem cell transplantation.
Transpl Infect Dis. 2015 Feb;17(1):33-8. doi: 10.1111/tid.12323. Epub 2014 Dec 27.
6
Multiresistant Pseudomonas aeruginosa outbreak in a pediatric oncology ward related to bath toys.
Pediatr Infect Dis J. 1998 Jun;17(6):509-13. doi: 10.1097/00006454-199806000-00015.
7
Pseudomonas aeruginosa bacteraemia: independent risk factors for mortality and impact of resistance on outcome.
J Med Microbiol. 2014 Dec;63(Pt 12):1679-1687. doi: 10.1099/jmm.0.073262-0. Epub 2014 Sep 26.
8
Population-based study of the epidemiology and the risk factors for Pseudomonas aeruginosa bloodstream infection.
Infection. 2010 Feb;38(1):25-32. doi: 10.1007/s15010-009-9145-9. Epub 2009 Dec 12.
9
Pseudomonas aeruginosa bloodstream infections in children: a 9-year retrospective study.
Eur J Pediatr. 2020 Aug;179(8):1247-1254. doi: 10.1007/s00431-020-03598-4. Epub 2020 Feb 21.
10
Multidrug-resistant Pseudomonas aeruginosa infections pose growing threat to health care-associated infection control in the hospitals of Southern China: a case-control surveillance study.
Am J Infect Control. 2014 Dec;42(12):1308-11. doi: 10.1016/j.ajic.2014.08.006. Epub 2014 Oct 16.
引用本文的文献
1
Clinical Analysis of Infections in Children Undergoing Chemotherapy or Hematopoietic Cell Transplantation: A Multicenter Nationwide Study.
J Clin Med. 2025 May 26;14(11):3714. doi: 10.3390/jcm14113714.
2
Experience in Ceftazidime-Avibactam for treatment of MDR BGN infection in Oncologic Children.
Braz J Infect Dis. 2025 Mar-Apr;29(2):104515. doi: 10.1016/j.bjid.2025.104515. Epub 2025 Feb 21.
3
Increased rate of multidrug-resistant gram-negative bacterial infections in hospitalized immunocompromised pediatric patients.
Front Cell Infect Microbiol. 2025 Jan 6;14:1382500. doi: 10.3389/fcimb.2024.1382500. eCollection 2024.
4
Bacteriophages and Their Clinical Applications.
Viruses. 2024 Jun 29;16(7):1051. doi: 10.3390/v16071051.
5
and related antibiotic resistance genes as indicators for wastewater treatment.
Heliyon. 2024 Apr 20;10(9):e29798. doi: 10.1016/j.heliyon.2024.e29798. eCollection 2024 May 15.
6
: Infections and novel approaches to treatment "Knowing the enemy" the threat of and exploring novel approaches to treatment.
Infect Med (Beijing). 2023 May 26;2(3):178-194. doi: 10.1016/j.imj.2023.05.003. eCollection 2023 Sep.
7
Increase in Incidence Rates and Risk Factors for Multidrug Resistant Bacteria in Septic Children: A Nationwide Spanish Cohort Study (2013-2019).
Antibiotics (Basel). 2023 Nov 14;12(11):1626. doi: 10.3390/antibiotics12111626.
8
Better Outcome of Off-Label High-Dose Ceftazidime in Hemato-Oncological Patients with Infections Caused by Extensively Drug-Resistant .
Mediterr J Hematol Infect Dis. 2023 Jan 1;15(1):e2023001. doi: 10.4084/MJHID.2023.001. eCollection 2023.
9
Characteristics and Outcomes of Bloodstream Infections in a Tertiary-Care Pediatric Hematology-Oncology Unit: A 10-Year Study.
J Clin Med. 2022 Feb 8;11(3):880. doi: 10.3390/jcm11030880.
10
Gut Microbiome Modulation and Faecal Microbiota Transplantation Following Allogenic Hematopoietic Stem Cell Transplantation.
Cancers (Basel). 2021 Sep 17;13(18):4665. doi: 10.3390/cancers13184665.
本文引用的文献
1
Factors associated with bacteremia due to multidrug-resistant Gram-negative bacilli in hematopoietic stem cell transplant recipients.
Braz J Med Biol Res. 2009 Mar;42(3):289-93. doi: 10.1590/s0100-879x2009000300010.
2
Patterns of domestic migrations and access to childhood cancer care centres in Italy: a report from the hospital based registry of the Italian Association of Pediatric Hematology and Oncology (AIEOP).
Eur J Cancer. 2008 Oct;44(15):2101-5. doi: 10.1016/j.ejca.2008.07.023. Epub 2008 Aug 20.
3
Inappropriate initial antimicrobial therapy as a risk factor for mortality in patients with community-onset Pseudomonas aeruginosa bacteraemia.
Eur J Clin Microbiol Infect Dis. 2008 Dec;27(12):1219-25. doi: 10.1007/s10096-008-0568-5. Epub 2008 Jun 25.
4
Healthcare-associated infections in pediatric cancer patients: results of a prospective surveillance study from university hospitals in Germany and Switzerland.
BMC Infect Dis. 2008 May 23;8:70. doi: 10.1186/1471-2334-8-70.
5
Incidence of bacteremias and invasive mycoses in children undergoing allogeneic hematopoietic stem cell transplantation: a single center experience.
Bone Marrow Transplant. 2008 Feb;41(4):339-47. doi: 10.1038/sj.bmt.1705921. Epub 2007 Nov 19.
6
Invasive Pseudomonas aeruginosa infections: high rate of recurrence and mortality after hematopoietic cell transplantation.
Bone Marrow Transplant. 2007 Jun;39(11):687-93. doi: 10.1038/sj.bmt.1705653. Epub 2007 Apr 2.
7
Pseudomonas aeruginosa: resistance and therapeutic options at the turn of the new millennium.
Clin Microbiol Infect. 2007 Jun;13(6):560-78. doi: 10.1111/j.1469-0691.2007.01681.x. Epub 2007 Jan 31.
8
Impact of empiric antibiotic therapy on outcomes in patients with Pseudomonas aeruginosa bacteremia.
Antimicrob Agents Chemother. 2007 Mar;51(3):839-44. doi: 10.1128/AAC.00901-06. Epub 2006 Dec 28.
9
Cost of Gram-negative resistance.
Crit Care Med. 2007 Jan;35(1):89-95. doi: 10.1097/01.CCM.0000251496.61520.75.
10
Nosocomial infections due to multidrug-resistant Pseudomonas aeruginosa: epidemiology and treatment options.
Pharmacotherapy. 2005 Oct;25(10):1353-64. doi: 10.1592/phco.2005.25.10.1353.
Zotero 插件