+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Bloodstream infections in pediatric patients with acute leukemia: Emphasis on gram-negative bacteria infections



Bloodstream infections in pediatric patients with acute leukemia: Emphasis on gram-negative bacteria infections



Journal of Microbiology Immunology and Infection 50(4): 507-513



Acute leukemia is the most common pediatric hematological malignancy. Bloodstream infections (BSIs) are severe complications in these patients during chemotherapy. This study aims to explore clinical features, laboratory, and microbiological characteristics of BSIs in acute leukemic children. Patients aged < 18 years, diagnosed with acute myeloid leukemia or acute lymphocytic leukemia with BSIs from January 2004 to December 2013 were enrolled. BSIs was defined as positive isolate(s) of blood culture and associated with clinical findings. Clinical presentations, demographic features, and microbiological findings were retrospectively reviewed. In total, 126 isolates of 115 episodes of BSIs were identified from 69 patients (acute lymphocytic leukemia 56; acute myeloid leukemia 13). Gram-negative bacteria (GNB), gram-positive cocci, and fungi constituted 56.3%, 42.3%, and 2.4% of the pathogens, respectively. Eighty-three and a half percent of BSIs occurred along with neutropenia, and 73% had severe neutropenia. GNB was the leading pathogen of BSIs. The major GNBs were Escherichia coli, Klebsiella pneumonia, and Pseudomonas aeruginosa. White blood cell counts, absolute neutrophil counts, and platelet counts were significantly lower in patients of BSIs caused by GNB than gram-positive cocci. Plasma level of C-reactive protein was significant high in patients of GNB BSIs (179.8 mg/L vs. 127.2 mg/L; p = 0.005). Eighty-two percent of patients of E. coli, K. pneumonia, and P. aeruginosa BSIs had sepsis related organ failure or organ dysfunction. P. aeruginosa BSIs had the highest case-mortality (40%). Neutropenia was the major risk factor of BSIs in pediatric leukemic patients. BSIs of GNB were associated with severe neutropenia, systemic inflammatory responses, and high mortality.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 057314937

Download citation: RISBibTeXText

PMID: 26442676

DOI: 10.1016/j.jmii.2015.08.013


Related references

Increased Costs Associated with Bloodstream Infections Caused by Multidrug-Resistant Gram-Negative Bacteria Are Due Primarily to Patients with Hospital-Acquired Infections. Antimicrobial Agents and ChemoTherapy 61(3):, 2017

Evaluation of clinical outcomes in patients with bloodstream infections due to Gram-negative bacteria according to carbapenem MIC stratification. Antimicrobial Agents and ChemoTherapy 56(9): 4885-4890, 2012

Impact of body mass index on clinical outcomes in patients with gram-negative bacteria bloodstream infections. Journal of Infection and ChemoTherapy 22(10): 671-676, 2016

Characterization and anti-microbial susceptibility of gram-negative bacteria isolated from bloodstream infections of cancer patients on chemotherapy in Pakistan. Indian Journal of Medical Microbiology 27(4): 341-347, 2009

Predictive value of the kinetics of procalcitonin and C-reactive protein for early clinical stability in patients with bloodstream infections due to Gram-negative bacteria. Diagnostic Microbiology and Infectious Disease 93(1): 63-68, 2019

Antibiotic resistance of gram-negative bacilli isolated from pediatric patients with nosocomial bloodstream infections in a Mexican tertiary care hospital. ChemoTherapy 59(5): 361-368, 2013

Catheter-related bloodstream infections caused by Gram-negative bacteria. Journal of Hospital Infection 85(4): 316-320, 2013

Bloodstream infections in a medical-surgical intensive care unit: incidence, aetiology, antimicrobial resistance patterns of Gram-positive and Gram-negative bacteria. Clinical Microbiology and Infection 15(10): 943-946, 2009

Prediction of Fluoroquinolone Resistance in Gram-Negative Bacteria Causing Bloodstream Infections. Antimicrobial Agents and ChemoTherapy 60(4): 2265-2272, 2016

Use of Tigecycline in Pediatric Patients With Infections Predominantly Due to Extensively Drug-Resistant Gram-Negative Bacteria. Journal of the Pediatric Infectious Diseases Society 6(2): 123-128, 2017

Clinical Characteristics of Bloodstream Infections in Pediatric Acute Leukemia: A Single-center Experience with 231 Patients. Chinese Medical Journal 130(17): 2076-2081, 2017

Predictors of mortality in bloodstream infections caused by multidrug-resistant gram-negative bacteria: 4 years of collection. American Journal of Infection Control (): -, 2016

In vitro activity of isepamicin and other aminoglycosides against clinical isolates of Gram-negative bacteria causing nosocomial bloodstream infections. Journal of Microbiology, Immunology, and Infection 40(6): 481-486, 2007

Carbapenem-resistant Gram-negative bacteria associated with catheter-related bloodstream infections in three intensive care units in Egypt. European Journal of Clinical Microbiology and Infectious Diseases 37(9): 1647-1652, 2018

Geographical variability in the likelihood of bloodstream infections due to gram-negative bacteria: correlation with proximity to the equator and health care expenditure. Plos one 9(12): E114548, 2014