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儿科癌症患者尿液和血液中分离的尿路病原体细菌的抗生素耐药性:一项单中心、12 年研究。

Resistance to Antibiotics of Uropathogen Bacteria Isolated From Urine and Blood in Pediatric Cancer Patients: A Single Center, 12-year Study.

机构信息

From the IRCCS Istituto Giannina Gaslini, Genova, Italy.

出版信息

Pediatr Infect Dis J. 2020 Dec;39(12):1106-1110. doi: 10.1097/INF.0000000000002854.

Abstract

Resistant pathogens have become a major healthcare problem in children with cancer, causing different kinds of infections such as the bloodstream ones, most common, and most frequently described and the urinary tract ones, of which less data are available. We analyzed and compared the proportions, and the trends of resistance in pathogens isolated from blood and urines in children with cancer followed in IRCCS Istituto Giannina Gaslini, Genova, Italy, from January 2007 to December 2018. Overall, 345 strains detected in urines and 282 in bloodstream infections were analyzed. Enterobacteriales were the most frequently isolated pathogens. During the study period in urines, there was a significant increase of resistance to ceftazidime, ciprofloxacin, piperacillin/tazobactam, and trimethoprim-sulfamethoxazole, but pathogens from blood were significantly more frequently resistant to amikacin, piperacillin/tazobactam, and combination therapy piperacillin/tazobactam+amikacin, even if with a decreasing trend during the study period. These data confirm the importance of surveillance of isolated microorganism and antibiotic resistance in cancer children.

摘要

耐药病原体已成为癌症儿童的主要医疗保健问题,导致各种感染,如最常见且经常描述的血流感染和尿路感染,而尿路感染的数据较少。我们分析并比较了意大利热那亚 Giannina Gaslini 研究所儿童癌症监测中心(IRCCS Istituto Giannina Gaslini) 2007 年 1 月至 2018 年 12 月期间从血液和尿液中分离出的病原体的比例和耐药趋势。总体而言,分析了尿液中检测到的 345 株和血流感染中检测到的 282 株病原体。肠杆菌科是最常分离到的病原体。在研究期间,尿液中对头孢他啶、环丙沙星、哌拉西林/他唑巴坦和复方磺胺甲噁唑的耐药性显著增加,但血液中的病原体对阿米卡星、哌拉西林/他唑巴坦和哌拉西林/他唑巴坦联合氨基糖苷类(如阿米卡星)的耐药性显著增加,尽管在研究期间呈下降趋势。这些数据证实了监测癌症儿童分离微生物和抗生素耐药性的重要性。

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