Bacteremia in pediatric patients with hematopoietic stem cell transplantation

Pérez, Paola; Patiño, Jaime; Estacio, Mayra; Pino, Jessica; Manzi, Eliana; Medina, Diego

doi:10.1016/j.htct.2019.05.006

Cited by 10 publications

(6 citation statements)

References 32 publications

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“…This is considered very low compared with 20% risk as per Akinboyo IC et al when antibiotics prophylaxis was not used in 1294 pediatric HSCT patients, although the majority of HSCTs were from cord blood 2 . Perez et al 10 studied 111 pediatric haploidentical HSCT patients and showed a higher rate of infections (41.4%) in the first 100 days post‐HSCT despite using antibacterial prophylaxis.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial prophylaxis and the rate of blood stream infections and Clostridioides difficile in pediatric stem cell transplantation: A single‐center retrospective study

Alrugaib

Alsultan

Elbashir

et al. 2022

Pediatric Transplantation

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Background:The use of prophylactic antibiotics in the pre-engraftment period to minimize the risk of bacteremia is debatable given concerns of Clostridioides difficile (C. diff), antibiotics resistance, and disruption of gut microbiota. Methods:We retrospectively reviewed the rate and characteristics of bacteremia and C. diff infections within the first 100 days post-HSCT in all pediatric patients who received routine antibacterial prophylaxis during HSCT from 2015 to 2018. C. diff infection was defined by the presence of three or more unformed stools in 24 h and positive stool test for C. diff or its toxins.Results: One hundred and thirty-five (100 allogeneic and 35 autologous) transplants in 123 patients were eligible for analysis. Median age at transplant was 7.1 (range 0.2-13.7), 67 (55%) were women, and diagnosis was malignant condition in 68 patients.Median time to neutrophil engraftment was 18 days (13-23). Cefepime or piperacillintazobactam prophylaxis was used in 105 (78%) and 28 (21%) of patients, respectively.Only five (3%) patients had bacteremia during the pre-engraftment period, and 13 (11%) patients developed bacteremia postengraftment. Septic shock was present in only one patient pre-engraftment and was due to gram-negative bacteria. All patients who developed bacteremia received MAC. Thirteen patients (10%) of patients fulfilled C. diff infection definition. There was no mortality related to bacterial infections among our patients. Conclusions:The use of antibiotic prophylaxis was associated with low rate of bacteremia in the pre-engraftment period and a 10% risk of C. diff infections. More studies are needed to better evaluate the efficacy of antibiotic prophylaxis in HSCT patients.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial prophylaxis and the rate of blood stream infections and Clostridioides difficile in pediatric stem cell transplantation: A single‐center retrospective study

Alrugaib

Alsultan

Elbashir

et al. 2022

Pediatric Transplantation

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“…21 With regard to children undergoing hematopoietic stem cell transplantation or children with malignancies, bacteremia caused by resistant microorganisms, especially carbapenem-resistant strains, is also associated with higher mortality rates. 23,[28][29][30]…”

Section: Discussionmentioning

confidence: 99%

Attributable Mortality for Pediatric and Neonatal Central Line-Associated Bloodstream Infections in Greece

Karagiannidou¹,

Kourlaba²,

Zaoutis

et al. 2021

J Pediatr Intensive Care

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Central line-associated bloodstream infections (CLABSIs) are the most frequent pediatric hospital-acquired infections and significantly impact outcomes. The aim of this study was to estimate the attributable mortality for CLABSIs in pediatric and neonatal patients in Greece. A retrospective matched-cohort study was performed, in two tertiary pediatric hospitals. Inpatients with a central line in neonatal and pediatric intensive care units (NICUs and PICUs), hematology/oncology units, and a bone marrow transplantation unit between June 2012 and June 2015 were eligible. Patients with confirmed CLABSI were enrolled on the day of the event and were matched (1:1) to non-CLABSI patients by hospital, hospitalization unit, and length of stay prior to study enrollment (188 children enrolled, 94 CLABSIs). Attributable mortality was estimated. During the study period, 22 CLABSIs and nine non-CLABSIs died (23.4 vs. 9.6%, respectively, p = 0.011), leading to an attributable mortality of 13.8% (95% confidence interval [CI] = 3.4–24.3%). Children in PICUs were more likely to die, presenting an attributable mortality of 20.2% (95% CI = − 1.4–41.8%), without reaching, however, statistical significance. After multiple logistic regression, CLABSIs were four times more likely to die (odds ratio [OR] = 4.29, 95% CI = 1.28–14.36, p = 0.018). Survival analysis showed no difference in time to death after study enrollment between CLABSIs and non-CLABSIs (log-rank p = 0.137, overall median survival time = 7.8 months). Greek pediatric mortality rates are increased by the CLABSI occurrence, highlighting the importance of infection prevention strategies.

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“…These inflammatory regulators were assessed as potential targets for OM prevention and management. Additionally, promotion of opportunistic pathogens exacerbates OM and may result in secondary infections [ 42 , 43 ]. Smaller spherical AuNPs with positive surface charge are effective antimicrobials suggesting therapeutic benefit.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of gold nanoparticles in prevention and treatment of oral mucositis in animal models: a systematic review

Choudhury,

Brunton,

Schwass

et al. 2024

Syst Rev

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Background Oral mucositis remains a significant complication during cancer therapy with no effective treatment. Gold nanoparticles offer anti-inflammatory, antioxidant properties with low toxicity. This study systematically reviews the literature assessing gold nanoparticles in the management of oral mucositis in animal models. Methods A literature search was undertaken using MEDLINE, Embase, PubMed, and Web of Science databases, using the format for Systematic Review Centre for Laboratory Animal Experimentation. Prior to the review, the protocol was registered in the systematic review register, PROSPERO (registration no. CRD42021272169). Outcome measures included ulceration, histopathological scores, inflammatory mediators, microbial growth, and pain. Study quality was analysed by SYRCLE risk-of-bias tool. Results Only one study met the inclusion criteria, documenting reduction in ulceration, inflammatory, and oxidative biomarkers. Exposure to AuNPs prevented inflammatory response induced by 5-fluorouracil in oral mucosa of hamsters. However, a high risk of bias necessitates further research. Conclusion This review identifies a potential therapeutic strategy for prevention and management of oral mucositis. It also provides future direction for gold nanoparticle research in oral mucositis; however, there is lack of sufficient evidence to derive any conclusion. Research with standardized parameters including nanoparticle size, capping agent, surface charge, and appropriate oral mucositis animal models will establish risk–benefit balance and margin of safety for therapeutic use of gold nanoparticles for oral mucositis.

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Bacteremia in pediatric patients with hematopoietic stem cell transplantation

Cited by 10 publications

References 32 publications

Antimicrobial prophylaxis and the rate of blood stream infections and Clostridioides difficile in pediatric stem cell transplantation: A single‐center retrospective study

Antimicrobial prophylaxis and the rate of blood stream infections and Clostridioides difficile in pediatric stem cell transplantation: A single‐center retrospective study

Attributable Mortality for Pediatric and Neonatal Central Line-Associated Bloodstream Infections in Greece

Effectiveness of gold nanoparticles in prevention and treatment of oral mucositis in animal models: a systematic review

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