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Infections with Klebsiella pneumoniae in Children Undergoing Anticancer Therapy or Hematopoietic Cell Transplantation: A Multicenter Nationwide Study.
Sekowska, Alicja; Czyzewski, Krzysztof; Jaremek, Kamila; Zalas-Wiecek, Patrycja; Zajac-Spychala, Olga; Wachowiak, Jacek; Szmydki-Baran, Anna; Hutnik, Lukasz; Gietka, Agnieszka; Gryniewicz-Kwiatkowska, Olga; Dembowska-Baginska, Bozenna; Semczuk, Katarzyna; Dzierzanowska-Fangrat, Katarzyna; Czogala, Wojciech; Balwierz, Walentyna; Zak, Iwona; Tomaszewska, Renata; Szczepanski, Tomasz; Bien, Ewa; Irga-Jaworska, Ninela; Machnik, Katarzyna; Urbanska-Rakus, Justyna; Pajak, Sonia; Plonowski, Marcin; Krawczuk-Rybak, Maryna; Królak, Aleksandra; Ociepa, Tomasz; Urasinski, Tomasz; Wawryków, Pawel; Peregud-Pogorzelski, Jaroslaw; Brzeski, Tomasz; Mycko, Katarzyna; Manko-Glinska, Hanna; Badowska, Wanda; Urbanek-Dadela, Agnieszka; Karolczyk, Grazyna; Stolpa, Weronika; Skowron-Kandzia, Katarzyna; Mizia-Malarz, Agnieszka; Pierlejewski, Filip; Mlynarski, Wojciech; Musial, Jakub; Chaber, Radoslaw; Zawitkowska, Joanna; Zaucha-Prazmo, Agnieszka; Drabko, Katarzyna; Gozdzik, Jolanta; Fraczkiewicz, Jowita; Salamonowicz-Bodzioch, Malgorzata; Kalwak, Krzysztof.
Afiliación
  • Sekowska A; Microbiology Department, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-094 Bydgoszcz, Poland.
  • Czyzewski K; Department of Pediatrics, Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University in Torun, 85-094 Bydgoszcz, Poland.
  • Jaremek K; Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, 61-701 Poznan, Poland.
  • Zalas-Wiecek P; Department of Pediatrics, Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University in Torun, 85-094 Bydgoszcz, Poland.
  • Zajac-Spychala O; Microbiology Department, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-094 Bydgoszcz, Poland.
  • Wachowiak J; Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, 61-701 Poznan, Poland.
  • Szmydki-Baran A; Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, 61-701 Poznan, Poland.
  • Hutnik L; Department of Oncology, Pediatric Hematology, Clinical Transplantation and Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland.
  • Gietka A; Department of Oncology, Pediatric Hematology, Clinical Transplantation and Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland.
  • Gryniewicz-Kwiatkowska O; Department of Oncology, Children's Memorial Health Institute, 04-730 Warsaw, Poland.
  • Dembowska-Baginska B; Department of Oncology, Children's Memorial Health Institute, 04-730 Warsaw, Poland.
  • Semczuk K; Department of Oncology, Children's Memorial Health Institute, 04-730 Warsaw, Poland.
  • Dzierzanowska-Fangrat K; Department of Clinical Microbiology and Immunology, Children's Memorial Health Institute, 04-730 Warsaw, Poland.
  • Czogala W; Department of Clinical Microbiology and Immunology, Children's Memorial Health Institute, 04-730 Warsaw, Poland.
  • Balwierz W; Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 31-008 Krakow, Poland.
  • Zak I; Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 31-008 Krakow, Poland.
  • Tomaszewska R; Department of Microbiology, University Children's Hospital, 30-663 Krakow, Poland.
  • Szczepanski T; Department of Pediatric Hematology and Oncology, Silesian Medical University, 41-808 Zabrze, Poland.
  • Bien E; Department of Pediatric Hematology and Oncology, Silesian Medical University, 41-808 Zabrze, Poland.
  • Irga-Jaworska N; Department of Pediatrics, Hematology and Oncology, Medical University, 80-210 Gdansk, Poland.
  • Machnik K; Department of Pediatrics, Hematology and Oncology, Medical University, 80-210 Gdansk, Poland.
  • Urbanska-Rakus J; Division of Pediatric Hematology and Oncology, Chorzow City Hospital, 41-500 Chorzow, Poland.
  • Pajak S; Division of Pediatric Hematology and Oncology, Chorzow City Hospital, 41-500 Chorzow, Poland.
  • Plonowski M; Division of Pediatric Hematology and Oncology, Chorzow City Hospital, 41-500 Chorzow, Poland.
  • Krawczuk-Rybak M; Department of Pediatric Oncology and Hematology, Medical University, 15-089 Bialystok, Poland.
  • Królak A; Department of Pediatric Oncology and Hematology, Medical University, 15-089 Bialystok, Poland.
  • Ociepa T; Department of Pediatrics, Pediatric Hematooncology and Gastroenterology, Pomeranian Medical University, 70-204 Szczecin, Poland.
  • Urasinski T; Department of Pediatrics, Pediatric Hematooncology and Gastroenterology, Pomeranian Medical University, 70-204 Szczecin, Poland.
  • Wawryków P; Department of Pediatrics, Pediatric Hematooncology and Gastroenterology, Pomeranian Medical University, 70-204 Szczecin, Poland.
  • Peregud-Pogorzelski J; Department of Pediatrics, Pediatric Oncology and Immunology, Pomeranian Medical University, 70-204 Szczecin, Poland.
  • Brzeski T; Department of Pediatrics, Pediatric Oncology and Immunology, Pomeranian Medical University, 70-204 Szczecin, Poland.
  • Mycko K; Department of Clinical Pediatrics University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland.
  • Manko-Glinska H; Clinical Divison of Pediatric Oncology and Hematology, Regional Specialised Children's Hospital in Olsztyn, 10-561 Olsztyn, Poland.
  • Badowska W; Department of Clinical Pediatrics University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland.
  • Urbanek-Dadela A; Clinical Divison of Pediatric Oncology and Hematology, Regional Specialised Children's Hospital in Olsztyn, 10-561 Olsztyn, Poland.
  • Karolczyk G; Department of Clinical Pediatrics University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland.
  • Stolpa W; Clinical Divison of Pediatric Oncology and Hematology, Regional Specialised Children's Hospital in Olsztyn, 10-561 Olsztyn, Poland.
  • Skowron-Kandzia K; Department of Clinical Pediatrics University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland.
  • Mizia-Malarz A; Clinical Divison of Pediatric Oncology and Hematology, Regional Specialised Children's Hospital in Olsztyn, 10-561 Olsztyn, Poland.
  • Pierlejewski F; Division of Pediatric Hematology and Oncology, Children Hospital, 25-736 Kielce, Poland.
  • Mlynarski W; Division of Pediatric Hematology and Oncology, Children Hospital, 25-736 Kielce, Poland.
  • Musial J; Division of Pediatric Oncology, Hematology and Chemotherapy, Department of Pediatric, Silesian Medical University, 40-055 Katowice, Poland.
  • Chaber R; Division of Pediatric Oncology, Hematology and Chemotherapy, Department of Pediatric, Silesian Medical University, 40-055 Katowice, Poland.
  • Zawitkowska J; Division of Pediatric Oncology, Hematology and Chemotherapy, Department of Pediatric, Silesian Medical University, 40-055 Katowice, Poland.
  • Zaucha-Prazmo A; Department of Pediatrics, Hematology and Oncology, Medical University, 90-419 Lodz, Poland.
  • Drabko K; Department of Pediatrics, Hematology and Oncology, Medical University, 90-419 Lodz, Poland.
  • Gozdzik J; Department of Pediatric Oncohematology, Medical Faculty University of Rzeszow, Clinical Provincial Hospital No. 2, 35-301 Rzeszow, Poland.
  • Fraczkiewicz J; Department of Pediatric Oncohematology, Medical Faculty University of Rzeszow, Clinical Provincial Hospital No. 2, 35-301 Rzeszow, Poland.
  • Salamonowicz-Bodzioch M; Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-059 Lublin, Poland.
  • Kalwak K; Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-059 Lublin, Poland.
J Clin Med ; 13(14)2024 Jul 12.
Article en En | MEDLINE | ID: mdl-39064118
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 ß-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.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Polonia
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Polonia