Pathogenesis of bloodstream infection in children with blood cancer.
Pathogenesis of bloodstream infection in children with blood cancer.
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血癌患儿血流感染的发病机制
DOI：
10.3892/etm.2012.738
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发表时间：
2013-01
影响因子：
2.7
通讯作者：
Ning B
中科院分区：
文献类型：
--
作者：
Lv H;Ning B
本研究的目的是描述2010年1月至12月浙江大学医学院附属儿童医院血液肿瘤科血流感染（BSI）患者分离的病原体的分布和抗生素耐药性，并为临床抗生素的早期和适当的管理提供支持。对1,500例住院患儿中161例按国家标准诊断为BSI的患儿进行回顾性分析。中性粒细胞减少定义为外周血中性粒细胞绝对计数（ANC）低于0.5×109个细胞/l。微生物学记录的感染（MDI）定义为从血液中分离出致病病原体。药敏试验采用VITEK-60全自动微生物分析仪和Kirby-Bauer纸片扩散法进行。使用STATA软件（9.0版）分析数据，认为双侧P值≤0.05表示具有统计学显著性差异。从血液标本中共分离出79株细菌。BSI发生率为10.73%（161/1,500）。细菌感染中革兰阳性球菌占55.70%，革兰阴性杆菌占43.04%，真菌占1.27%。常见分离菌为表皮葡萄球菌（20.25%）、大肠埃希菌（15.19%）和肺炎克雷伯菌（15.19%）。葡萄球菌对万古霉素和利奈唑胺敏感，大肠埃希菌和肺炎克雷伯菌对头孢哌酮/舒巴坦、亚胺培南和美罗培南敏感。结论：BSI中革兰阳性菌略多于革兰阴性菌，根据药敏结果选择抗生素上级经验性治疗。早期适当地使用抗菌药物治疗BSI儿童血癌患者至关重要。
The aim of the present study was to characterize the distribution and antibiotic resistance of pathogens isolated from patients with bloodstream infections (BSIs) in the Hematology and Oncology department of the Affiliated Children’s Hospital of Zhejiang University Medical School (Hangzhou, China), between January and December 2010 and to provide early and appropriate support for the clinical administration of antibiotics. Out of 1,500 inpatients, 161 children who were diagnosed with BSI based on the national diagnostic criteria were retrospectively analyzed. Neutropenia was defined as an absolute neutrophil count (ANC) in the peripheral blood of less than 0.5×109 cells/l. A microbiologically documented infection (MDI) was defined as when the causative pathogen was isolated from the blood. Drug susceptibility tests were performed using a VITEK-60 AutoMicrobic System and the Kirby-Bauer disk diffusion method. The data were analyzed using STATA software (version 9.0) and a two-sided P-value of ≤0.05 was considered to indicate a statistically significant difference. A total of 79 strains were isolated from the blood specimens. The incidence of BSI was 10.73% (161/1,500). Gram-positive cocci, Gram-negative bacilli and fungi accounted for 55.70, 43.04 and 1.27% of the BSIs, respectively. Staphylococcus epidermidis (20.25%), Escherichia coli (15.19%) and Klebsiella pneumoniae (15.19%) were frequently identified isolates. The staphylococci were susceptible to vancomycin and linezolid, while Escherichia coli and Klebsiella pneumoniae were sensitive to cefoperazone/sulbactam, imipenem and meropenem. In conclusion, Gram-positive bacteria are slightly more prevalent than Gram-negative bacteria in BSI and the selection of antibiotics according to the susceptibility test results is superior to empirical treatment. It is essential to administer antimicrobial agents early and appropriately to treat child blood cancer patients with BSI.
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影响因子：
2
作者：
Celkan, T;Ozkan, A;Yildiz, I
通讯作者：
Yildiz, I
影响因子：
8.4
作者：
Tromp, Yvonne H.;Daenen, Simon M. G. J.;Vellenga, Edo
通讯作者：
Vellenga, Edo
影响因子：
11.4
作者：
Lehrnbecher, T;Varwig, D;Creutzig, U
通讯作者：
Creutzig, U
影响因子：
3.2
作者：
Dowzicky, Michael J.;Park, Chocing H.
通讯作者：
Park, Chocing H.
影响因子：
14.2
作者：
Tang, Y.;Liao, C.;Pan, B.
通讯作者：
Pan, B.