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病例报告:一例急性淋巴细胞白血病患儿的罕见多重耐药感染及文献综述

Case Report: A rare infection of multidrug-resistant in a pediatric case with acute lymphoblastic leukemia and review of the literature.

作者信息

Dai Yiling, Gao Ju, Jiang Mingyan

机构信息

Department of Pediatric Hematology and Oncology, West China Second University Hospital, Sichuan University, Chengdu, China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China.

出版信息

Front Pediatr. 2024 May 13;12:1233600. doi: 10.3389/fped.2024.1233600. eCollection 2024.

DOI:10.3389/fped.2024.1233600
PMID:38803640
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11128555/
Abstract

infection of the bloodstream and intestine is a rare and severe opportunistic infection in immunocompromised people. In Southwest China, we first reported a case of bloodstream and intestinal infection with multidrug-resistant (MDR) in a 4-year-old child with T-cell acute lymphoblastic leukemia. Blood and stool cultures were used to identify the infection. The selection of antibiotics was based on clinical expertise and medication sensitivity tests. We used linezolid, levofloxacin, and polymyxin B to treat the patient aggressively. infection is uncommon in juvenile acute lymphoblastic leukemia. Doctors should be aware of the likelihood of opportunistic infection during the post-chemotherapy bone marrow suppression period. We further conducted a review of the literature and performed a detailed analysis of s infection in pediatric leukemia. It is becoming increasingly apparent that antibiotic is abused domestically and abroad, resulting in the sharp increase of MDR bacteria. In general, most of the isolates are susceptible to third- or fourth-generation cephalosporins, aminoglycosides, quinolones, and carbapenem, but drug-resistant strains are being reported increasingly. We summarized the drug resistance rate of s caviae and in China in the last 10 years. Early recognition and effective treatment will improve prognosis and reduce mortality.

摘要

血流和肠道感染在免疫功能低下人群中是一种罕见且严重的机会性感染。在中国西南部,我们首次报道了一例4岁T细胞急性淋巴细胞白血病患儿发生的耐多药血流和肠道感染病例。通过血液和粪便培养来确定感染情况。抗生素的选择基于临床经验和药物敏感性试验。我们使用利奈唑胺、左氧氟沙星和多粘菌素B对该患者进行积极治疗。感染在青少年急性淋巴细胞白血病中并不常见。医生应意识到化疗后骨髓抑制期发生机会性感染的可能性。我们进一步对文献进行了综述,并对儿童白血病中的感染进行了详细分析。国内外抗生素滥用现象日益明显,导致耐多药细菌急剧增加。一般来说,大多数分离株对第三代或第四代头孢菌素、氨基糖苷类、喹诺酮类和碳青霉烯类敏感,但耐药菌株的报道越来越多。我们总结了过去10年中国豚鼠气单胞菌和嗜水气单胞菌的耐药率。早期识别和有效治疗将改善预后并降低死亡率。

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