一家儿科造血干细胞移植中心爆发的中心管路相关性血流感染,与Ralstonia picketti污染的生理盐水有关。

Safiye Suna Çelen, Suleimen Zhumatayev, Koray Yalçın, Manolya Kara, Murat Sütçü, Gülsün Karasu, M Akif Yeşilipek
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引用次数: 0

摘要

背景:Ralstonia pickettii 是一种需氧革兰阴性非发酵性杆菌。它是一种机会性病原体,近来引发了院内爆发。虽然它的毒力较低,但在免疫抑制患者中可引起多种侵袭性疾病。本研究介绍了在小儿造血干细胞移植(HSCT)受者中爆发的R.picketti相关中心管路相关血流感染(CLABSI)的特点:这是一项在巴赫切希尔大学戈兹特佩医疗园医院进行的单中心回顾性分析。分析了 12 例与 Ralstonia 相关的 CLABSIs 患儿的临床和实验室特征:结果:在12例R.pickettii感染患者中,7例为女性。中位年龄为 12.1(2-17)岁。其中两名患者接受了自体造血干细胞移植,十名患者因恶性和非恶性疾病接受了异体造血干细胞移植。在调理方案中,所有患者都接受了骨髓溶解治疗。临床败血症是最常见的表现。调查结果显示,在生理盐水中观察到了皮卡氏菌的生长。所有病例均成功接受了适当的抗生素治疗,并且在重复培养中未发现该细菌。两名患者需要拔除导管。没有发现任何患者因感染而死亡:结论:对于患有严重免疫抑制的儿科造血干细胞移植患者来说,检测和控制感染源至关重要,因为与医疗设备相关的感染爆发可能会危及生命。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Central line-associated bloodstream infection outbreak related to Ralstonia pickettii-contaminated saline in a pediatric hematopoietic stem cell transplant center.

Background: Ralstonia pickettii is an aerobic Gram-negative non-fermentative bacillus. It is an opportunistic pathogen that has recently prompted nosocomial outbreaks. Although it has low virulence, it can cause a wide range of invasive diseases in immunosuppressive patients. The characteristics of R. pickettii-related central line-associated bloodstream infection (CLABSI) outbreak in pediatric hematopoietic stem cell transplant (HSCT) recipients are presented in this study.

Materials and methods: This was a single-center, retrospective analysis conducted at Bahcesehir University Goztepe Medicalpark Hospital . The clinical and laboratory characteristics of twelve children with Ralstonia-related CLABSIs were analyzed.

Results: Of the twelve patients with R. pickettii growth, seven were female. The median age was 12.1 (2-17) years. Autologous HSCT was performed in two of the patients and allogeneic HSCT was performed in ten patients for both malignant and non-malignant diseases. In the conditioning regimens, all patients were given myeloablative therapy. Clinical sepsis was the most common presentation. As a result of the investigations, R. pickettii growth was observed in saline solutions. All cases were successfully treated with the appropriate antibiotic regimen and the bacteria was not found in repeat cultures. Catheter removal was required in two patients. Mortality was not observed in any patient as the outcome of the infection episode.

Conclusion: The detection and control of the infectious source are critical in pediatric HSCT patients with severe immunosuppression, as medical equipment-related outbreaks can be life-threatening.

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