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铜绿假单胞菌菌血症的儿科患者:病例系列研究。

Pseudomonas putida bacteremia in pediatric patients: A case series study.

机构信息

Epidemiological Control and Infectious Disease Service, Hospital Nacional de Pediatría SAMIC Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina.

Epidemiological Control and Infectious Disease Service, Hospital Nacional de Pediatría SAMIC Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina.

出版信息

Enferm Infecc Microbiol Clin (Engl Ed). 2023 Apr;41(4):221-224. doi: 10.1016/j.eimce.2022.07.007. Epub 2022 Jul 28.

Abstract

INTRODUCTION

Bacteria of the genus Pseudomonas act as opportunistic pathogens. Pseudomonas putida has been considered a pathogen of low virulence and susceptible to multiple antibiotics, but in recent years resistant strains have emerged. The objective of this study is to describe the clinical characteristics, evolution and antibiotic resistance of P. putida bacteremia documented in pediatric hospitalized patients.

METHODS

Retrospective cases series. Pediatric patients admitted to the Prof. Dr. Juan P. Garrahan Hospital of Buenos Aires City, Argentina, with isolation in blood cultures of P. putida were included, between August 2015 and August 2020.

RESULTS

Sample consisting of 13 patients. Median age: 81 months (IQR 15-163). Ten of the patients were immunocompromised (77%), 11 (85%) had a central venous catheter, 2 (15%) received transfusions prior to the episode of bacteremia, and 6 (46%) had had an invasive procedure within the previous 30 days. Three patients (23%) presented bacteremia secondary to clinical focus and 10 (77%) had central venous catheter-associated bacteremia. All presented fever, 62% (8) evolved with sepsis and 15% (2) with septic shock. Two patients required admission to the intensive care unit (15%), and in 7 (54%) the central venous catheter was removed. None died. The median days of treatment was 14 (IQR 10-14). Resistance to carbapenems was 30%.

CONCLUSION

All children had underlying comorbidities, most of them immunocompromised. Catheter-associated infection predominated. The sensitivity to antibiotics was variable. Given the emergence of multi-resistant strains, it is essential to know the local epidemiology.

摘要

简介

假单胞菌属的细菌是机会性病原体。铜绿假单胞菌被认为是一种低毒力的病原体,且易受多种抗生素的影响,但近年来已出现耐药菌株。本研究的目的是描述在阿根廷布宜诺斯艾利斯市胡安·P·加兰医院住院的小儿患者中,有记录的铜绿假单胞菌菌血症的临床特征、演变和抗生素耐药情况。

方法

回顾性病例系列研究。纳入 2015 年 8 月至 2020 年 8 月期间,在阿根廷布宜诺斯艾利斯市胡安·P·加兰医院的血培养中分离出铜绿假单胞菌的小儿住院患者。

结果

样本包括 13 例患者。中位年龄:81 个月(IQR 15-163)。10 例患者免疫功能低下(77%),11 例(85%)有中心静脉导管,2 例(15%)在发生菌血症前接受过输血,6 例(46%)在过去 30 天内进行过有创操作。3 例(23%)患者为临床相关的菌血症,10 例(77%)为中心静脉导管相关性菌血症。所有患者均有发热,62%(8 例)出现脓毒症,15%(2 例)出现感染性休克。2 例患者(15%)需要入住重症监护病房,7 例(54%)患者的中心静脉导管被拔除。无死亡病例。中位治疗时间为 14 天(IQR 10-14)。对碳青霉烯类药物的耐药率为 30%。

结论

所有患儿均存在潜在的合并症,大多数患儿存在免疫功能低下。感染以导管相关性感染为主。抗生素的敏感性各不相同。鉴于多耐药菌株的出现,了解当地的流行病学情况至关重要。

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