Prevalence of multi-drug resistant organisms in stool of paediatric patients with acute leukaemia and correlation with blood culture positivity: A single institution experience
| Autor: | Krupa Shankar, Jaikumar Ramamoorthy, Manikandan Dhanushkodi, Trivadi S. Ganesan, Prasanth Ganesan, Tenali Gnana Sagar, Venkatraman Radhakrishnan, Varalakskmi Vijayakumar |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Adolescent medicine.drug_class Concordance 030106 microbiology Cephalosporin Antibiotics Microbial Sensitivity Tests 03 medical and health sciences Feces 0302 clinical medicine Internal medicine Drug Resistance Multiple Bacterial medicine Prevalence Humans Blood culture 030212 general & internal medicine Single institution Child Paediatric patients Leukemia medicine.diagnostic_test Bacteria business.industry Infant Hematology Bacterial Infections Antimicrobial Anti-Bacterial Agents Multi-Drug Resistant Organism Oncology Child Preschool Pediatrics Perinatology and Child Health Immunology Acute Disease Female business |
| Zdroj: | Pediatric bloodcancer. 65(1) |
| ISSN: | 1545-5017 |
| Popis: | Background Multi-drug resistant (MDR) bacteria are associated with increased morbidity and mortality in children with acute leukaemia. The present study was conducted to assess the prevalence of MDR bacteria in stool cultures of patients with acute leukaemia at presentation to the hospital. The results were then correlated with blood cultures when patients developed septicaemia. Patients and methods The study involved analysis of case records of patients with newly diagnosed acute leukaemia less than 18 years of age treated at our centre from January 2015 to December 2015. Stool cultures were sent within 72 hr of hospital admission and blood cultures were sent when clinically indicated. MDR was defined as resistance to at least one antibiotic in three or more following antimicrobial groups: cephalosporins, β-lactam/β-lactamase inhibitor, carbapenems, fluoroquinolones and aminoglycosides. Results The analysis included 85 patients with acute leukaemia, among whom 48 of 85 (56%) patients had positive stool cultures and 42 of 85 (50%) patients were positive for MDR bacteria. Blood cultures were positive in 13 of 48 patients (27%, seven MDR and six non-MDR) with positive stool cultures and three of 37 patients (8%, one MDR and two non-MDR) with negative stool cultures (P = 0.01). The concordance between stool and blood culture for similar organism was 61%. There were seven deaths in 48 stool culture positive patients and two deaths in 37 stool culture negative patients. Conclusion This study shows the high prevalence of MDR bacteria in newly diagnosed children with acute leukaemia. Colonisation with MDR bacteria in stools is associated with increased positivity of blood cultures and mortality. |
| Databáze: | OpenAIRE |
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