■洋葱伯克霍尔德菌(B.洋葱)是携带囊性纤维化的儿科患者医院感染的新兴病原体。关于洋葱芽孢杆菌感染的临床诊断和治疗研究甚少。这项研究概述了风险因素,抗菌敏感性,旨在提高洋葱芽孢杆菌感染的治疗方法和临床特点。
■对50例不囊性纤维化患儿由洋葱芽孢杆菌引起的感染病例进行了回顾性研究,在厦门大学附属第一医院确诊,从1月1日,2011年12月31日,2021年。
■共有50名儿童感染了洋葱芽孢杆菌,其中68%有潜在的健康状况,如心血管疾病(23.5%),呼吸系统疾病(17.6%),神经系统疾病(14.7%),和肿瘤性疾病(14.7%)。在洋葱芽孢杆菌感染开始时,42名(84%)儿科患者在重症监护病房(ICU),33人(66%)接受气管插管,32(64%)有中心静脉导管(CVC)。此外,医院获得性病例为46例(92%),医疗保健获得的病例为4例(12%)。最常见的感染部位是呼吸道(68%),其次是血液(20%),和泌尿道(12%)。结果表明,百合菌对头孢他啶最敏感(95.65%),其次是甲氧苄啶-磺胺甲恶唑(88.68%),美罗培南(82.98%),头孢吡肟(77.78%),和左氧氟沙星(55.85%)。哌拉西林他唑巴坦的耐药率,米诺环素,氨曲南,头孢哌酮-舒巴坦和头孢曲松均高于55%。38例治愈或好转,八人终止了治疗,四人死亡。
■B洋葱是一种机会性病原体,通常在免疫功能低下的儿科患者中发现,极有可能导致耐药性。根据我们的观察,医院内的洋葱芽孢杆菌感染主要发生在ICU患者中。包括改变流行病学和增加微生物耐药性在内的洋葱芽孢杆菌感染的监测仍然非常重要。用有效的抗生素如头孢他啶治疗,美罗培南,甲氧苄啶-磺胺甲恶唑与良好的预后相关。
UNASSIGNED: Burkholderia cepacia (B. cepacia) is an emerging pathogen of nosocomial infection in pediatric patient carrying cystic fibrosis. The clinical diagnosis and treatment of B. cepacia infection remains poorly studied. This study outlined the risk factors, antimicrobial susceptibility, and clinical characteristics aiming to improve the treatment of B. cepacia infection.
UNASSIGNED: A retrospective study was conducted based on the 50 cases infection caused by B. cepacia in children without cystic fibrosis, which were diagnosed in the First Affiliated Hospital of Xiamen University, from January 1st, 2011 to December 31st, 2021.
UNASSIGNED: A total of 50 children were infected with B. cepacia, of whom 68% had an underlying health condition, such as cardiovascular disease (23.5%), respiratory disease (17.6%), nervous system disease (14.7%), and neoplastic disease (14.7%). At the onset of B. cepacia infection, 42 (84%) pediatric patients were in an intensive care unit (ICU), 33 (66%) underwent endotracheal intubation, and 32 (64%) had a central venous catheter (CVC). In addition, hospital-acquired cases were 46 (92%), and healthcare-acquired cases were 4 (12%). The most common infectious sites of B. cepacia were the respiratory tract (68%), followed by the blood (20%), and the urinary tract (12%). It indicated that B. cepacia was the most sensitive to ceftazidime (95.65%), followed by trimethoprim-sulfamethoxazole (88.68%), meropenem (82.98%), cefepime (77.78%), and levofloxacin (55.85%). The drug resistance rate of piperacillin-tazobactam, minocycline, aztreonam, cefoperazone-sulbactam and ceftriaxone was higher than 55%. 38 cases were cured or improved, eight had treatment terminated, and four died.
UNASSIGNED: B. cepacia is an opportunistic pathogen normally found in immunocompromised pediatric patients and highly likely to lead to drug resistance. Nosocomial B. cepacia infections occurred mostly in patients in the ICU based on our observations. The surveillance of B. cepacia infections including changing epidemiology and increasing resistance of the microorganism is still very important. Treatment with effective antibiotics such as ceftazidime, meropenem, trimethoprim-sulfamethoxazole is associated with a favorable prognosis.