Nosocomial Non-fermentative gram negative bacteria bloodstream infections in children; Risk factors and clinical outcomes of carbapenem resistance |
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| Authors: | Gizem Guner Ozenen Zumrut Sahbudak Bal Zuhal Umit Gulhadiye Avcu Duygu Tekin Zafer Kurugol Feriha Cilli Ferda Ozkinay |
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| Affiliation: | 1. Medical School of Ege University, Division of Infectious Disease, Department of Pediatrics, Izmir, Turkey;2. Medical School of Ege University, Department of Microbiology and Infectious Diseases, Izmir, Turkey;1. Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;2. Department of Infection Control and Prevention, Faculty of Medicine, The University of Tokyo, Japan;3. Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Tokyo, Japan;1. Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan;2. Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan;3. Department of Orthopedics, Aichi Medical University Hospital, Nagakute, Aichi, Japan;1. Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan;2. Department of Orthopedic Surgery, St. Hill Hospital, Ube, Japan;1. Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA;2. Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA;3. Department of Family Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA;4. Sanford Health, North Dakota, USA;5. University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA;1. Department of Microbiology, Tokyo Medical University, Tokyo, Japan;2. Department of Infectious Diseases, St Luke''s International Hospital, Tokyo, Japan;3. Metaboscreen Company, Ltd., Kanagawa, Japan;4. Department of Microbiology, St. Marianna University School of Medicine, Kanagawa, Japan;5. Graduate School of Public Health, St. Luke''s International University, Tokyo, Japan;6. Department of Infectious Diseases, International University of Health and Welfare, Chiba, Japan |
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| Abstract: | IntroductionNon-fermentative Gram-negative bacterias (NFGNBs) are a major cause of life threatening infections in hospitalized children. In this study, we aimed to evaluate the demographic and clinical characteristics of NFGNBs infections and identify the risk factors and outcomes of bloodstream infections (BSIs) caused by carbapenem-resistant (CR) NFGNBs infections.MethodsA retrospective cohort was designed to evaluate the patients with a BSI caused by NFGNBs between in January 2014 and December 2017.ResultsA total of 131 episodes from 115 patients were evaluated. The mean age of the patients was 4.79±(4.74) year. The most commonly isolated NFGNBs species was Acinetobacter spp. (35.9%), Pseudomonas spp. (34.4%), and Stenotrophomonas maltophilia (13%). The rate of carbapenem-resistance was 38.2% in Acinetobacter spp. and 26.6% in Pseudomonas spp. The comparison of CR group with carbapenem-susceptible (CS) group showed statistical significance for the length of hospital stay prior to onset of infection and total hospital stay (P values were 0.001, 0.008). Based on the univariate analysis, requirement of mechanical ventilation, central venous catheter, nasogastric tube, Foley catheter, severe neutropenia (<100/mm3), prolonged neutropenia (≥14 days), prior intensive care unit admission and prior antimicrobial treatment (carbapenems, colistin, glycopeptide) were more common in carbapenem-resistant NFGNBs infections (P values are 0.001, 0.012, 0.000, 0.005, 0.042, 0.027, 0.007, 0.007). In patients with NFGNBs infections 14-day and 30-day mortality rates were %16.8 and 21.4%.ConclusionCR infections were more common in children with prolonged and severe neutropenia. Prior antimicrobial use and intensive care unit admission were more common in CR infections. |
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| Keywords: | Carbapenem resitance Non-fermentative gram negative bacteria Pediatric |
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