Infections with Klebsiella pneumoniae in Children Undergoing Anticancer Therapy or Hematopoietic Cell Transplantation: A Multicenter Nationwide Study-Reference-Cited by-同舟云学术

Infections with Klebsiella pneumoniae in Children Undergoing Anticancer Therapy or Hematopoietic Cell Transplantation: A Multicenter Nationwide Study

Published:2024-07-12 Issue:14 Volume:13 Page:4078
ISSN:2077-0383
Container-title:Journal of Clinical Medicine
language:en
Short-container-title:JCM

Author:

Sękowska Alicja¹^ORCID,Czyżewski Krzysztof²³^ORCID,Jaremek Kamila²^ORCID,Zalas-Więcek Patrycja¹^ORCID,Zając-Spychała Olga³,Wachowiak Jacek³,Szmydki-Baran Anna⁴,Hutnik Łukasz⁴,Gietka Agnieszka⁵,Gryniewicz-Kwiatkowska Olga⁵,Dembowska-Bagińska Bożenna⁵^ORCID,Semczuk Katarzyna⁶,Dzierżanowska-Fangrat Katarzyna⁶,Czogała Wojciech⁷^ORCID,Balwierz Walentyna⁷^ORCID,Żak Iwona⁸^ORCID,Tomaszewska Renata⁹,Szczepański Tomasz⁹^ORCID,Bień Ewa¹⁰,Irga-Jaworska Ninela¹⁰,Machnik Katarzyna¹¹,Urbańska-Rakus Justyna¹¹,Pająk Sonia¹¹,Płonowski Marcin¹²,Krawczuk-Rybak Maryna¹²,Królak Aleksandra¹³,Ociepa Tomasz¹³,Urasiński Tomasz¹³,Wawryków Paweł¹⁴,Peregud-Pogorzelski Jarosław¹⁴,Brzeski Tomasz¹⁵¹⁶,Mycko Katarzyna¹⁵¹⁶,Mańko-Glińska Hanna¹⁵¹⁶,Badowska Wanda¹⁵¹⁶,Urbanek-Dądela Agnieszka¹⁷,Karolczyk Grażyna¹⁷,Stolpa Weronika¹⁸,Skowron-Kandzia Katarzyna¹⁸,Mizia-Malarz Agnieszka¹⁸^ORCID,Pierlejewski Filip¹⁹,Młynarski Wojciech¹⁹^ORCID,Musiał Jakub²⁰,Chaber Radosław²⁰^ORCID,Zawitkowska Joanna²¹^ORCID,Zaucha-Prażmo Agnieszka²¹^ORCID,Drabko Katarzyna²¹,Goździk Jolanta²²,Frączkiewicz Jowita²³,Salamonowicz-Bodzioch Małgorzata²³,Kałwak Krzysztof²³^ORCID,Styczyński Jan²^ORCID

Affiliation:

1. Microbiology Department, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-094 Bydgoszcz, Poland

2. Department of Pediatrics, Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University in Torun, 85-094 Bydgoszcz, Poland

3. Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, 61-701 Poznan, Poland

4. Department of Oncology, Pediatric Hematology, Clinical Transplantation and Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland

5. Department of Oncology, Children’s Memorial Health Institute, 04-730 Warsaw, Poland

6. Department of Clinical Microbiology and Immunology, Children’s Memorial Health Institute, 04-730 Warsaw, Poland

7. Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 31-008 Krakow, Poland

8. Department of Microbiology, University Children’s Hospital, 30-663 Krakow, Poland

9. Department of Pediatric Hematology and Oncology, Silesian Medical University, 41-808 Zabrze, Poland

10. Department of Pediatrics, Hematology and Oncology, Medical University, 80-210 Gdansk, Poland

11. Division of Pediatric Hematology and Oncology, Chorzow City Hospital, 41-500 Chorzow, Poland

12. Department of Pediatric Oncology and Hematology, Medical University, 15-089 Bialystok, Poland

13. Department of Pediatrics, Pediatric Hematooncology and Gastroenterology, Pomeranian Medical University, 70-204 Szczecin, Poland

14. Department of Pediatrics, Pediatric Oncology and Immunology, Pomeranian Medical University, 70-204 Szczecin, Poland

15. Department of Clinical Pediatrics University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland

16. Clinical Divison of Pediatric Oncology and Hematology, Regional Specialised Children’s Hospital in Olsztyn, 10-561 Olsztyn, Poland

17. Division of Pediatric Hematology and Oncology, Children Hospital, 25-736 Kielce, Poland

18. Division of Pediatric Oncology, Hematology and Chemotherapy, Department of Pediatric, Silesian Medical University, 40-055 Katowice, Poland

19. Department of Pediatrics, Hematology and Oncology, Medical University, 90-419 Lodz, Poland

20. Department of Pediatric Oncohematology, Medical Faculty University of Rzeszow, Clinical Provincial Hospital No. 2, 35-301 Rzeszow, Poland

21. Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-059 Lublin, Poland

22. Stem Cell Transplant Center, University Children’s Hospital, Department of Clinical Immunology and Transplantology, Jagiellonian University Collegium Medicum, 31-008 Krakow, Poland

23. Department of Pediatric Hematology, Oncology and BMT, Wroclaw Medical University, 50-367 Wrocław, Poland

Abstract

Background: Klebsiella pneumoniae is a nosocomial pathogen that causes severe infections in immunocompromised patients. The aim of the study was to conduct a microbiological and clinical analysis of K. pneumoniae infections in children with malignancies or undergoing hematopoietic cell transplantation in Poland. Methods: We conducted a retrospective, multicenter study including children and adolescents under 19 years old treated between 2012 and 2021. We analyzed patients’ characteristics, microbiological data, and the outcomes of antibiotic therapy. Results: A total of 9121 newly diagnosed children were treated for malignancy and 1697 pediatric patients underwent hematopoietic cell transplantation. K. pneumoniae infections were diagnosed in 527 patients. Their overall incidence was 4.86% in pediatric hematology and oncology patients and 4.95% in patients who underwent hematopoietic cell transplantation. The incidence of infection was higher in patients with acute leukemia than with solid tumors (7.8% vs. 4.1%; OR = 2.0; 95% CI = 1.6–2.4; p < 0.0001). The most frequent source of infection was in the urinary tract at 55.2%. More than 57% of K. pneumoniae strains were extended-spectrum β-lactamase-positive and almost 34% were multidrug-resistant. Infections with K. pneumoniae contributed to death in 3.22% of patients. Conclusions: K. pneumoniae is one of the most critical pathogens in children suffering from malignancies or undergoing hematopoietic cell transplantation. The incidence of multidrug-resistant K. pneumoniae strains is increasing and contributing to poor clinical outcome.

Publisher

MDPI AG

Link

https://www.mdpi.com/2077-0383/13/14/4078/pdf

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