Tekeli Onur, Kara Tuğce Tural, Çetin Hafize Selma, Kızıl Hatice Burcu Çağlar, Açık Ayşe Kübra, Küpesiz Funda Tayfun, Oğünç Meral Dilara
Akdeniz University, Faculty of Medicine, Department of Pediatric Infectious Diseases - Antalya, Turkey.
Akdeniz University, Faculty of Medicine, Department of Pediatric Hematology and Oncology - Antalya, Turkey.
Rev Assoc Med Bras (1992). 2025 Jul 7;71(6):e20241944. doi: 10.1590/1806-9282.20241944. eCollection 2025.
Rhizobium spp. strains (formerly classified as Agrobacterium based on 16S rDNA analysis) are aerobic, motile, oxidase-positive, non-spore-forming gram-negative bacilli. Clinical manifestations associated with Rhizobium radiobacter infections vary widely, with bacteremia typically linked to intravenous catheter use.
This study analyzes the clinical and laboratory characteristics of 11 pediatric hematology and oncology patients at a tertiary referral hospital who had Rhizobium radiobacter-associated bloodstream infections over a 3-month period.
Nine of the patients were male, and hematologic malignancy was the primary diagnosis in seven patients. Common risk factors included hospitalization within the last month, chemotherapy treatment, and the presence of an indwelling central venous catheter in all cases. Rhizobium radiobacter growth was detected an average of 13.5±16.6 days (range 1-54 days) after hospital admission, with 36% of patients being neutropenic at the time of culture positivity. Rhizobium radiobacter growth was detected in both catheter and peripheral blood cultures in six patients, whereas the microorganism was isolated exclusively from catheter cultures in four patients. Ten patients received antibiotic lock therapy, predominantly with amikacin (90%). Systemic antibiotic treatment involved a combination of beta-lactam and aminoglycoside antibiotics in 10 patients. Culture sterility was achieved in nine patients by the third day of antibiotic treatment. There were no cases of catheter extraction, thrombophlebitis, cardiac vegetation, reproductive complications, or mortality.
In this first pediatric case series utilizing antibiotic lock therapy, effective treatment, strict isolation, and surveillance screenings led to favorable clinical outcomes for Rhizobium radiobacter-associated bloodstream infections in children with hematologic and oncologic conditions.
根瘤菌属菌株（基于16S rDNA分析，以前归类为土壤杆菌属）是需氧、运动、氧化酶阳性、无芽孢形成的革兰氏阴性杆菌。与放射根瘤菌感染相关的临床表现差异很大，菌血症通常与静脉导管的使用有关。
本研究分析了一家三级转诊医院11例儿科血液学和肿瘤学患者的临床和实验室特征，这些患者在3个月内发生了与放射根瘤菌相关的血流感染。
9例患者为男性，7例患者的主要诊断为血液系统恶性肿瘤。常见的危险因素包括过去一个月内住院、化疗以及所有病例均存在留置中心静脉导管。入院后平均13.5±16.6天（范围1 - 54天）检测到放射根瘤菌生长，36%的患者在培养阳性时为中性粒细胞减少。6例患者的导管和外周血培养中均检测到放射根瘤菌生长，而4例患者仅从导管培养中分离出该微生物。10例患者接受了抗生素封管治疗，主要使用阿米卡星（90%）。10例患者的全身抗生素治疗采用了β-内酰胺类和氨基糖苷类抗生素联合使用。9例患者在抗生素治疗第三天实现了培养无菌。没有发生导管拔除、血栓性静脉炎、心脏赘生物、生殖系统并发症或死亡病例。
在这个首次使用抗生素封管治疗的儿科病例系列中，有效的治疗、严格的隔离和监测筛查为血液学和肿瘤学疾病患儿的放射根瘤菌相关血流感染带来了良好的临床结果。
