Mitsuboshi Akari, Kishimoto Kenji, Ito Yusuke, Ishida Toshiaki, Kasai Masashi, Hasegawa Daiichiro, Kosaka Yoshiyuki
Hematology and Oncology.
Department of Infectious Diseases, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan.
J Pediatr Hematol Oncol. 2023 Jan 1;45(1):21-24. doi: 10.1097/MPH.0000000000002524. Epub 2022 Aug 9.
Although infection is common in patients with cancer, the distribution of causative agents and the proportion of resistant bacteria in patients with urinary tract infection remain unknown. The aim of this study was to describe the incidence, the causative agents, and the proportion of antimicrobial resistance in bacteria cultured from urine of hospitalized children with cancer. A single-center retrospective chart review of patients with cancer admitted between 2012 and 2020 was performed to identify patients with positive urine culture. Overall, 61 (0.9%) of 7107 patients were identified to have positive urine cultures. Among them, 25 patients (41%) had symptomatic bacteriuria. The most common pathogenic bacterium among all patients was Escherichia coli ( E. coli ) (n=15, 25%), followed by Enterococcus sp. (n=14, 23%), Klebsiella sp. (n=12, 20%), and Pseudomonas aeruginosa ( P. aeruginosa ) (n=12, 20%). Extended spectrum β-lactamases-producing E. coli and Extended spectrum β-lactamases-producing Klebsiella pneumoniae were detected in 1 patient (2%) and 4 patients (7%), respectively. No multidrug-resistant P. aeruginosa and vancomycin-resistant Enterococcus were detected. The incidence of bacteriuria was found to be low in children with cancer. The distribution of causative agents of bacteriuria in children with solid tumors and hematologic diseases may be different from that in previously healthy children.
尽管感染在癌症患者中很常见，但尿路感染患者的病原体分布和耐药菌比例仍不清楚。本研究的目的是描述住院癌症儿童尿液培养细菌的感染发生率、病原体及抗菌药物耐药比例。对2012年至2020年间收治的癌症患者进行单中心回顾性病历审查，以确定尿培养阳性的患者。总体而言，7107例患者中有61例（0.9%）尿培养阳性。其中，25例患者（41%）有症状性菌尿。所有患者中最常见的病原菌是大肠埃希菌（大肠杆菌）（n = 15，25%），其次是肠球菌属（n = 14，23%）、克雷伯菌属（n = 12，20%）和铜绿假单胞菌（铜绿假单胞菌）（n = 12，20%）。分别在1例患者（2%）和4例患者（7%）中检测到产超广谱β-内酰胺酶的大肠埃希菌和产超广谱β-内酰胺酶的肺炎克雷伯菌。未检测到多重耐药铜绿假单胞菌和耐万古霉素肠球菌。发现癌症儿童菌尿的发生率较低。实体瘤和血液系统疾病儿童菌尿的病原体分布可能与以前健康的儿童不同。
