From the Department of Pediatrics B, Schneider Children's Medical Center, Petach Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv.
Pediatr Infect Dis J. 2019 Nov;38(11):1096-1099. doi: 10.1097/INF.0000000000002449.
The Flavobacteriaceae family includes rare pathogens in children; Chryseobacterium indologenes and Elizabethkingia meningosepticum are the most common pathogenic species, with a wide range of clinical presentations and high mortality rate. Although rare, diagnosis is important due to inherent resistance to multiple antibiotics, especially those typically prescribed for empiric treatment of aerobic Gram-negative bacterial infections.
A multicenter retrospective study conducted in 5 Israeli hospitals, describing Flavobacteriaceae bacteremia confirmed by positive blood culture from 1998 to 2018.
Thirteen cases were included; 9 isolates were C. indologenes. Bacteremia was nosocomial or healthcare-associated in all cases. Bacteremia was associated with young age (median, 1 year, range 24 days-17 years), with only 2 (15.4%) cases in neonates, Central line-associated bloodstream infection as a source (5/13, 38%) and malignancy (7/13, 54.8%). Thirty-day all-cause mortality was 23% (3/13). Ninety-one percent of isolates were susceptible to trimethoprim-sulfamethoxazole, 82% to piperacillin-tazobactam and 92% to ciprofloxacin.
C. indologenes and E. meningosepticum are rare, nosocomial- or healthcare-associated pediatric bacteremia pathogens. Bacteremia was associated with young age, but in contrast to the literature, the majority of our cases were older than the neonatal age period. In addition, they were associated with central line-associated bloodstream infection and malignancy. The most adequate antibiotics according to resistance patterns were ciprofloxacin, trimethoprim-sulfamethoxazole and piperacillin-tazobactam.
黄杆菌科包括儿童中罕见的病原体；食酸菌属和脑膜败血伊丽莎白菌是最常见的致病菌种，具有广泛的临床表现和高死亡率。尽管罕见，但由于对多种抗生素具有固有耐药性，尤其是那些通常用于经验性治疗需氧革兰氏阴性菌感染的抗生素，因此诊断很重要。
对 5 家以色列医院进行的一项多中心回顾性研究，描述了 1998 年至 2018 年通过阳性血培养确认的黄杆菌科菌血症。
共纳入 13 例病例；9 例分离株为食酸菌属。所有病例的菌血症均为医院获得性或与医疗保健相关。菌血症与年龄较小（中位数为 1 岁，范围为 24 天至 17 岁）有关，只有 2 例（15.4%）为新生儿，中央静脉导管相关血流感染为来源（5/13，38%）和恶性肿瘤（7/13，54.8%）。30 天全因死亡率为 23%（3/13）。91%的分离株对复方磺胺甲噁唑敏感，82%对哌拉西林他唑巴坦敏感，92%对环丙沙星敏感。
食酸菌属和脑膜败血伊丽莎白菌是罕见的医院获得性或与医疗保健相关的儿科菌血症病原体。菌血症与年龄较小有关，但与文献相比，我们的大多数病例年龄大于新生儿期。此外，它们与中央静脉导管相关血流感染和恶性肿瘤有关。根据耐药模式，最合适的抗生素是环丙沙星、复方磺胺甲噁唑和哌拉西林他唑巴坦。
