Etiologies of bacterial strains isolated from blood cultures of cancer pediatric patients
DOI:
https://doi.org/10.29327/2457362.65.66-9Keywords:
bloodstream infection, staphylococcus sp, klebsiella pneumoniae, escherichia coliAbstract
Introduction: Primary bloodstream infections (PBSIs) are serious adverse events, especially for vulnerable patients. Objectives: Data from pediatric ICUs indicate that PBSI cases are predominantly caused by coagulase-negative Staphylococcus, Staphylococcus aureus, Klebsiella pneumoniae complex, Serratia spp., and Pseudomonas aeruginosa. Of the total patients, 25 were neutropenic, and 5 were not. Methods: Data analysis showed that short-term catheters were more susceptible to PBSIs than long-term catheters. Results: The results indicated that the presence of onco-hematologic disease was a differentiating factor for positive blood cultures in neutropenic patients, where Staphylococcus epidermidis was the main agent identified among Gram-positive bacteria, and Klebsiella pneumoniae among Gram positive bacteria, which caused greater morbidity and mortality. Conclusions: Despite the limited evaluation of pathogenicity/virulence factors and the lack of investigation of antimicrobial resistance genes in the strains analyzed, it is considered that chemotherapy favors the translocation of intestinal bacteria. K. pneumoniae was the most frequent agent in PBSI cases, and probable changes may be due to colonization processes associated with the patients’ multiple hospitalizations.
References
Carvalho RV. Infecções por corinebactérias não diftéricas em cateter venoso central de pacientes oncológicos pediátricos [dissertation]. Rio de Janeiro (RJ): Universidade do Estado do Rio de Janeiro; 2015.
Agência Nacional de Vigilância Sanitária (Brasil), Unidade de Investigação e Prevenção das Infecções e dos Efeitos Adversos (UIPEA), Gerência Geral de Tecnologia em Serviços de Saúde (GGTES). Corrente sanguínea: critérios nacionais de infecções relacionadas à assistência à saúde [Internet]. 2008 [Cited 2019 Jan 04]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/criterios_diagnosticos_infeccoes_assistencia_saude.pdf.
Agência Nacional de Vigilância Sanitária (Brasil), Unidade de Investigação e Prevenção das Infecções e dos Efeitos Adversos (UIPEA). Gerência Geral de Tecnologia em Serviços de Saúde (GGTES). Manual de medidas de prevenção de Infecção Relacionada à Assistência à Saúde. 2017. Chapter 3.
Amancio L, Ihle Garcia Giamberardino H, Ferreira E, Matucheski B, Garcia Giamberardino AL. Epidemiological surveillance of health care-associated infections in a pediatric hematopoietic stem cell transplantation unit in South Brazil. Transpl Infect Dis [Internet]. 2021 Jun [Cited 2023 Oct 12]23(3):e13532. doi: 10.1111/tid.13532.
Böll B, Schalk E, Buchheidt D, Hasenkamp J, Kiehl M, Kiderlen TR, Kochanek M, Koldehoff M, Kostrewa P, Claßen AY, Mellinghoff SC, Metzner B, Penack O, Ruhnke M, Vehreschild MJGT, Weissinger F, Wolf HH, Karthaus M, Hentrich M. Central venous catheter-related infections in hematology and oncology: 2020 updated guidelines on diagnosis, management, and prevention by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Hematol [Internet]. 2021 Jan [Cited 2023 Oct 12]100(1):239-59. doi: 10.1007/s00277-020-04286-x.
Gowin E, Świątek-Kościelna B, Mańkowski P, Januszkiewicz-Lewandowska D. The profile of microorganisms responsible for port-related bacteremia in pediatric hemato-oncological patients. Cancer Control [Internet]. 2020 Jan-Dec [Cited 2023 Oct]27(1):1073274820904696. doi: 10.1177/1073274820904696.
Baier C, Linke L, Eder M, Schwab F, Chaberny IF, Vonberg RP, Ebadi E. Incidence, risk factors and healthcare costs of central line-associated nosocomial bloodstream infections in hematologic and oncologic patients. PLoS One [Internet]. 2020 Jan 24 [Cited 2019 Sep 18];15(1):e0227772. doi: 10.1371/journal.pone.0227772.
Ziegler MJ, Pellegrini DC, Safdar N. Attributable mortality of central line associated bloodstream infection: systematic review and meta-analysis. Infection [Internet]. 2015 Feb [Cited 2022 Oct 23];43(1):29-36. doi: 10.1007/s15010-014-0689-y.
Carvalho AS, Lagana D, Catford J, Shaw D, Bak N. Bloodstream infections in neutropenic patients with haematological malignancies. Infect Dis Health [Internet]. 2020 Feb [Cited 2021 Nov 22];25(1):22-9. doi: 10.1016/j.idh.2019.08.006.
Moskalewicz RL, Isenalumhe LL, Luu C, Wee CP, Nager AL. Bacteremia in nonneutropenic pediatric oncology patients with central venous catheters in the ED. Am J Emerg Med [Internet]. 2017 Jan [Cited 2022 Feb 10];35(1):20-4. doi: 10.1016/j.ajem.2016.09.028.
Kar Y D, Özdemir ZC, Bör Ö. Evaluation of febrile neutropenic attacks of pediatric hematology-oncology patients. Turk Pediatrics Ar [Internet]. 2017 Dec 1 [Cited 2021 Sep 12];52(4):213-20. doi: 10.5152/TurkPediatriArs.2017.5312.
Vázquez-López R, Rivero Rojas O, Ibarra Moreno A, Urrutia Favila JE, Peña Barreto A, Ortega Ortuño GL, Abello Vaamonde JA, Aguilar Velazco IA, Félix Castro JM, Solano-Gálvez SG, Barrientos Fortes T, González-Barrios JA. Antibiotic-resistant septicemia in pediatric oncology patients associated with post-therapeutic neutropenic fever. Antibiotics (Basel) [Internet]. 2019 Jul 30 [Cited 2021 Apr 25];8(3):106. doi: 10.3390/antibiotics8030106.
Heilmann C, Ziebuhr W, Becker K. Are coagulase-negative staphylococci virulent? Clin Microbiol Infect [Internet]. 2019 Sep [Cited 2019 Jan 14];25(9):1071-80. doi: 10.1016/j.cmi.2018.11.012.
Cui J, Li M, Cui J, Wang J, Qiang X, Liang Z. The proportion, species distribution and dynamic trends of bloodstream infection cases in a tertiary hospital in China, 2010-2019. Infection [Internet]. 2022 Feb [Cited 2023 Mar 23]50(1):121-30. doi: 10.1007/s15010-021-01649-y.
Lendak D, Puerta-Alcalde P, Moreno-García E, Chumbita M, García-Pouton N, Cardozo C, Morata L, Suárez-Lledó M, Hernández-Meneses M, Ghiglione L, Marco F, Martinez JA, Mensa J, Urošević I, Soriano A, Garcia-Vidal C. Changing epidemiology of catheter-related bloodstream infections in neutropenic oncohematological patients. PLoS One [Internet]. 2021 Apr 30 [Cited 2022 Jul 03]. 16(4):e0251010. doi: 10.1371/journal.pone.0251010.
Pinelli F, Cecero E, Degl’Innocenti D, Selmi V, Giua R, Villa G, Chelazzi C, Romagnoli S, Pittiruti M. Infection of totally implantable venous access devices: a review of the literature. J Vasc Access [Internet]. 2018 May [Cited 2020 Jul 20]19(3):230-42. doi: 10.1177/1129729818758999.
Özalp Gerçeker G, Yardımcı F, Aydınok Y. Central line-associated bloodstream infections in children with hematologic and oncologic diseases: first prevalence results from a university hospital. J Pediatr Oncol Nurs [Internet]. 2019 Sep/Oct [Cited 2022 Oct 23];36(5):327- 36. doi: 10.1177/1043454219844226.
Steinberg JP, Robichaux C, Tejedor SC, Reyes MD, Jacob JT. Distribution of pathogens in central line-associated bloodstream infections among patients with and without neutropenia following chemotherapy: evidence for a proposed modification to the current surveillance definition. Infect Control Hosp Epidemiol [Internet]. 2013 Feb [Cited 2020 Jul 16]34(2):171-5. doi: 10.1086/669082.
Schonardie AP, Beck E, Rigatto MH. Prevalence of bloodstream infection pathogens in hemato-oncological patients and predictors of carbapenem-resistant gram-negative bacterial infections during febrile neutropenia. Braz J Infect Dis [Internet]. 2023 Mar-Apr [Cited 2023 Oct 23]27(2):102758. doi: 10.1016/j.bjid.2023.102758.
Andrade MM, Luiz WB, da Silva Oliveira Souza R, Amorim JH. The History of Methicillin-Resistant Staphylococcus aureus in Brazil. Can J Infect Dis Med Microbiol [Internet]. 2020 Oct 7 [Cited 2021 Jun 23]2020:1721936. doi: 10.1155/2020/1721936.
Zuma AVP, Lima DF, Assef APDC, Marques EA, Leão RS. Molecular characterization of methicillin-resistant Staphylococcus aureus isolated from blood in Rio de Janeiro displaying susceptibility profiles to non-β-lactam antibiotics. Braz J Microbiol [Internet]. 2017 Apr-Jun [Cited 2021 Feb 17]48(2):237-41. doi: 10.1016/j.bjm.2016.09.016.
Rao K, Seekatz A, Bassis C, Sun Y, Mantlo E, Bachman MA. Enterobacterales Infection after Intestinal Dominance in Hospitalized Patients. mSphere [Internet]. 2020 Jul 22;5(4):e00450-20. doi: 10.1128/msphere.00450-20.
Aabed K, Moubayed N, Alzahrani S. Antimicrobial resistance patterns among different Escherichia coli isolates in the Kingdom of Saudi Arabia. Saudi J Biol Sci [Interent]. 2021 Jul [Cited 2023 Oct 12]28(7):3776-82. doi: 10.1016/j.sjbs.2021.03.047.
Olowo-Okere A, Ibrahim YKE, Olayinka BO. Molecular characterisation of extended-spectrum β-lactamase-producing Gram-negative bacterial isolates from surgical wounds of patients at a hospital in North Central Nigeria. J Glob Antimicrob Resist [Internet]. 2018 Sep [Cited 2022 Feb 10];14:85-9. doi: 10.1016/j.jgar.2018.02.002.
Ratchagame V, Prabakaran V. Comparison of risks from central venous catheters and peripheral intravenous lines among term neonates in a tertiary care hospital, India. J Caring Sci [Internet]. 2021 May 24 [Cited 2023 Oct 12]10(2):57-61. doi: 10.34172/jcs.2021.012.
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