The Pattern of Microorganisms and Drug Susceptibility in Pediatric Oncologic Patients with Febrile Neutropenia.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2021-03-29 eCollection Date: 2021-01-01 DOI:10.1155/2021/6692827

Thanyathorn Jungrungrueng, Suvaporn Anugulruengkitt, Supanun Lauhasurayotin, Kanhatai Chiengthong, Hansamon Poparn, Darintr Sosothikul, Piti Techavichit

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引用次数: 3

Abstract

Objective: The study aimed to describe the pattern of causative microorganisms, drug susceptibility, risk factors of antibiotic-resistant bacterial infection, and clinical impact of these organisms on pediatric oncology patients with febrile neutropenia.

Methods: A retrospective descriptive study of oncologic patients aged less than 15 years who were diagnosed with febrile neutropenia in King Chulalongkorn Memorial Hospital was conducted between January 2013 to December 2017. Characteristics and clinical outcomes of febrile neutropenia episodes, causative pathogens, and their antibiotic susceptibilities were recorded.

Result: This study included 267 patients with 563 febrile neutropenia episodes. The median (range) age was 5.1 years (1 month-15 years). The most common underlying disease was acute lymphoblastic leukemia (42.7%). Of 563 febrile episodes, there were 192 (34.1%) with microbiologically documented infection. Among these 192 episodes of microbiologically documented infection, there were 214 causative pathogens: 154 bacteria (72%), 32 viruses (15%), 27 fungus (12.6%), and 1 Mycobacterium tuberculosis (0.4%). Gram-negative bacteria (48.6%) accounted for most of the causative pathogens. Twenty-three percent of them were multidrug resistant, and 18% were carbapenem resistant. Among Gram-positive bacterial infection which accounted for 23.4% of all specimens, the proportion of MRSA was 20%. The 2-week mortality rate was 3.7%. Drug-resistant Gram-negative bacterial infection caused significant adverse events and mortality compared to nonresistant bacterial infection (p < 0.05).

Conclusion: There is high rate of drug-resistant organism infection in pediatric oncology patients in a tertiary-care center in Thailand. Infection with drug-resistant Gram-negative bacterial infection was associated with significant morbidity and mortality. Continuous surveillance for the pattern of drug-resistant infections is crucial.

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小儿肿瘤患者发热性中性粒细胞减少症的微生物及药敏模式。

目的:探讨小儿肿瘤科发热性中性粒细胞减少症患者的病原微生物、药敏、耐药菌感染的危险因素及其临床影响。方法:对2013年1月至2017年12月在朱拉隆功国王纪念医院诊断为发热性中性粒细胞减少症的年龄小于15岁的肿瘤患者进行回顾性描述性研究。记录发热性中性粒细胞减少发作的特点和临床结果、致病菌及其抗生素敏感性。结果:本研究纳入267例563次发热性中性粒细胞减少发作。中位(范围)年龄为5.1岁(1个月-15岁)。最常见的基础疾病是急性淋巴细胞白血病(42.7%)。在563例发热发作中，192例(34.1%)有微生物学记录的感染。在这192例微生物学记录的感染中，有214例致病病原体:细菌154例(72%)，病毒32例(15%)，真菌27例(12.6%)，结核分枝杆菌1例(0.4%)。革兰氏阴性菌占致病菌的绝大多数(48.6%)。其中23%对多药耐药，18%对碳青霉烯耐药。革兰氏阳性菌感染占全部标本的23.4%，MRSA所占比例为20%。2周死亡率为3.7%。耐药革兰氏阴性细菌感染与非耐药细菌感染相比，有显著的不良事件和死亡率(p < 0.05)。结论:泰国某三级医疗中心儿童肿瘤患者耐药菌感染率较高。耐药革兰氏阴性细菌感染与显著的发病率和死亡率相关。持续监测耐药感染的模式至关重要。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.