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儿科白血病患者的细菌病原体谱及抗生素耐药性:优化免疫功能低下儿童感染管理的见解

Bacterial Pathogen Profiles and Antibiotic Resistance in Pediatric Leukemia Patients: Insights for Optimizing Infection Management in Immunocompromised Children.

作者信息

Singer Cristina Elena, Popescu Alin Iulian Silviu, Văruț Renata Maria, Popescu Mihaela, Loredana Dira, Radivojevic Kristina, Octavia Petrescu Ileana

机构信息

Department of Mother and Baby, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.

Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.

出版信息

Antibiotics (Basel). 2024 Dec 22;13(12):1234. doi: 10.3390/antibiotics13121234.

Abstract

This study investigates bacterial etiology and antibiotic resistance in pediatric leukemia patients to determine the impact of chronic pathology on treatment efficacy. : Thirty cases of children aged 1-16 years (18 boys, 12 girls) were analyzed, identifying 13 pathogens, including 8 Gram-positive and 5 Gram-negative bacteria. : Among the patients, 11 girls presented with acute lymphoblastic leukemia (ALL) type B, while one boy and one girl had acute myeloid leukemia, and, as for boys, three had ALL type T and two had pre-B ALL. The most common pathogens were methicillin-resistant (MRSA, 11 patients), methicillin-sensitive (MSSA, 6 patients), spp., and . Due to the patients' compromised health, most required intensive care and strong antibiotic regimens, including linezolid, vancomycin, and ertapenem, which showed limited resistance. : These findings highlight the critical importance of understanding bacterial resistance patterns to guide effective treatments in vulnerable populations. Knowing specific resistance profiles can be lifesaving, allowing for tailored therapies that improve survival rates in children with leukemia facing serious bacterial infections. Focusing on the dual aspects of pediatric patients and multidrug-resistant bacterial infections, this study aims to highlight the importance of addressing these factors together to enhance therapeutic approaches in vulnerable populations.

摘要

本研究调查小儿白血病患者的细菌病因及抗生素耐药性,以确定慢性病理状况对治疗效果的影响。分析了30例1至16岁儿童(18名男孩,12名女孩),鉴定出13种病原体,包括8种革兰氏阳性菌和5种革兰氏阴性菌。在这些患者中,11名女孩患B型急性淋巴细胞白血病(ALL),1名男孩和1名女孩患急性髓细胞白血病,男孩中,3名患T型ALL,2名患前B ALL。最常见的病原体是耐甲氧西林金黄色葡萄球菌(MRSA,11例患者)、甲氧西林敏感金黄色葡萄球菌(MSSA,6例患者)、肺炎克雷伯菌属和大肠埃希菌属。由于患者健康状况不佳,大多数患者需要重症监护和强力抗生素治疗方案,包括利奈唑胺、万古霉素和厄他培南,这些药物显示出有限的耐药性。这些发现凸显了了解细菌耐药模式对指导脆弱人群有效治疗的至关重要性。了解特定的耐药情况可能挽救生命,使针对面临严重细菌感染的白血病患儿的治疗方案更具针对性,从而提高生存率。本研究聚焦于小儿患者和多重耐药细菌感染这两个方面,旨在强调共同应对这些因素以加强脆弱人群治疗方法的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8573/11672619/088624a47151/antibiotics-13-01234-g001.jpg

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