Bitte benutzen Sie diese Referenz, um auf diese Ressource zu verweisen:
doi:10.22028/D291-33665
Titel: | Antibiotic Resistant Bloodstream Infections in Pediatric Patients Receiving Chemotherapy or Hematopoietic Stem Cell Transplant: Factors Associated with Development of Resistance, Intensive Care Admission and Mortality |
VerfasserIn: | Castagnola, Elio Bagnasco, Francesca Mesini, Alessio Agyeman, Philipp K. A. Ammann, Roland A. Carlesse, Fabianne Santolaya de Pablo, Maria Elena Groll, Andreas H. Haeusler, Gabrielle M. Lehrnbecher, Thomas Simon, Arne D’Amico, Maria Rosaria Duong, Austin Idelevich, Evgeny A. Luckowitsch, Marie Meli, Mariaclaudia Menna, Giuseppe Palmert, Sasha Russo, Giovanna Sarno, Marco Solopova, Galina Tondo, Annalisa Traubici, Yona Sung, Lillian |
Sprache: | Englisch |
Titel: | Antibiotics |
Bandnummer: | 10 |
Heft: | 3 |
Verlag/Plattform: | MDPI |
Erscheinungsjahr: | 2021 |
Freie Schlagwörter: | antibiotic resistance intensive care admission and mortality bloodstream infections pediatric patients chemotherapy allogeneic stem cell transplant |
DDC-Sachgruppe: | 610 Medizin, Gesundheit |
Dokumenttyp: | Journalartikel / Zeitschriftenartikel |
Abstract: | Bloodstream infections (BSI) are a severe complication of antineoplastic chemotherapy or hematopoietic stem cell transplantation (HSCT), especially in the presence of antibiotic resistance (AR). A multinational, multicenter retrospective study in patients aged ≤ 18 years, treated with chemotherapy or HSCT from 2015 to 2017 was implemented to analyze AR among non-common skin commensals BSI. Risk factors associated with AR, intensive care unit (ICU) admission and mortality were analyzed by multilevel mixed effects or standard logistic regressions. A total of 1291 BSIs with 1379 strains were reported in 1031 patients. Among Gram-negatives more than 20% were resistant to ceftazidime, cefepime, piperacillin-tazobactam and ciprofloxacin while 9% was resistant to meropenem. Methicillin-resistance was observed in 17% of S. aureus and vancomycin resistance in 40% of E. faecium. Previous exposure to antibiotics, especially to carbapenems, was significantly associated with resistant Gram-negative BSI while previous colonization with methicillin-resistant S. aureus was associated with BSI due to this pathogen. Hematological malignancies, neutropenia and Gram-negatives resistant to >3 antibiotics were significantly associated with higher risk of ICU admission. Underlying disease in relapse/progression, previous exposure to antibiotics, and need of ICU admission were significantly associated with mortality. Center-level variation showed a greater impact on AR, while patient-level variation had more effect on ICU admission and mortality. Previous exposure to antibiotics or colonization by resistant pathogens can be the cause of AR BSI. Resistant Gram-negatives are significantly associated with ICU admission and mortality, with a significant role for the treating center too. The significant evidence of center-level variations on AR, ICU admission and mortality, stress the need for careful local antibiotic stewardship and infection control programs. |
DOI der Erstveröffentlichung: | 10.3390/antibiotics10030266 |
Link zu diesem Datensatz: | urn:nbn:de:bsz:291--ds-336658 hdl:20.500.11880/30980 http://dx.doi.org/10.22028/D291-33665 |
ISSN: | 2079-6382 |
Datum des Eintrags: | 29-Mär-2021 |
Bezeichnung des in Beziehung stehenden Objekts: | Supplementary Materials |
In Beziehung stehendes Objekt: | https://www.mdpi.com/2079-6382/10/3/266/s1 |
Fakultät: | M - Medizinische Fakultät |
Fachrichtung: | M - Pädiatrie |
Professur: | M - Keiner Professur zugeordnet |
Sammlung: | SciDok - Der Wissenschaftsserver der Universität des Saarlandes |
Dateien zu diesem Datensatz:
Datei | Beschreibung | Größe | Format | |
---|---|---|---|---|
antibiotics-10-00266-v2.pdf | 801,42 kB | Adobe PDF | Öffnen/Anzeigen |
Diese Ressource wurde unter folgender Copyright-Bestimmung veröffentlicht: Lizenz von Creative Commons