Bacteriemia por Pseudomonas putida en niños: serie de casos / Pseudomonas putida bacteremia in pediatric patients: A case series study

Introducción: Las bacterias del género Pseudomonas actúan como patógenos oportunistas. Pseudomonas putida se ha considerado un patógeno de baja virulencia y sensible a múltiples antibióticos, pero en los últimos años han emergido cepas resistentes. El objetivo de este estudio es describir las características clínicas, la evolución y la resistencia antibiótica de episodios de bacteriemia por P. putida en pacientes pediátricos internados. Métodos: Serie de casos retrospectiva. Se incluyeron pacientes pediátricos internados en el Hospital Prof. Dr. Juan P. Garrahan de la Ciudad de Buenos Aires, Argentina, con aislamiento en hemocultivos de P. putida, entre agosto de 2015 y agosto de 2020. Resultados: Muestra formada por 13 pacientes. Mediana de edad: 81 meses (RIC 15-163 meses). Diez pacientes eran inmunodeprimidos (77%), 11 (85%) tenían catéter venoso central, 2 (15%) recibieron transfusiones antes del episodio de bacteriemia y 6 (46%) habían tenido algún procedimiento invasivo en los 30 días previos. Tres pacientes (23%) presentaron bacteriemia secundaria a foco clínico y 10 (77%) bacteriemia asociada a catéter venoso central. Todos presentaron fiebre, el 62% (8) evolucionó con sepsis y el 15% (2) con shock séptico. Dos pacientes requirieron ingreso en la unidad de cuidados intensivos (15%), y en 7 (54%) se retiró el catéter venoso central. Ninguno falleció. La mediana de días de tratamiento fue de 14 (RIC 10-14). La resistencia a carbapenémicos fue del 30%. Conclusión: Todos los niños tuvieron comorbilidades subyacentes, en su mayoría inmunodepresión. Predominó la infección asociada a catéter. La sensibilidad a los antibióticos fue variable. Ante la emergencia de cepas multirresistentes, es fundamental conocer la epidemiología local.(AU)

Introduction: Bacteria of the genus Pseudomonas act as opportunistic pathogens. Pseudomonas putida has been considered a pathogen of low virulence and susceptible to multiple antibiotics, but in recent years resistant strains have emerged. The objective of this study is to describe the clinical characteristics, evolution and antibiotic resistance of P. putida bacteremia documented in pediatric hospitalized patients. Methods: Retrospective cases series. Pediatric patients admitted to the Prof. Dr. Juan P. Garrahan Hospital of Buenos Aires City, Argentina, with isolation in blood cultures of P. putida were included, between August 2015 and August 2020. Results: Sample consisting of 13 patients. Median age: 81 months (IQR 15-163). Ten of the patients were immunocompromised (77%), 11 (85%) had a central venous catheter, 2 (15%) received transfusions prior to the episode of bacteremia, and 6 (46%) had had an invasive procedure within the previous 30 days. Three patients (23%) presented bacteremia secondary to clinical focus and 10 (77%) had central venous catheter-associated bacteremia. All presented fever, 62% (8) evolved with sepsis and 15% (2) with septic shock. Two patients required admission to the intensive care unit (15%), and in 7 (54%) the central venous catheter was removed. None died. The median days of treatment was 14 (IQR 10-14). Resistance to carbapenems was 30%. Conclusion: All children had underlying comorbidities, most of them immunocompromised. Catheter-associated infection predominated. The sensitivity to antibiotics was variable. Given the emergence of multi-resistant strains, it is essential to know the local epidemiology.(AU)

Pseudomonas putida bacteremia in pediatric patients: A case series study.

INTRODUCTION: Bacteria of the genus Pseudomonas act as opportunistic pathogens. Pseudomonas putida has been considered a pathogen of low virulence and susceptible to multiple antibiotics, but in recent years resistant strains have emerged. The objective of this study is to describe the clinical characteristics, evolution and antibiotic resistance of P. putida bacteremia documented in pediatric hospitalized patients. METHODS: Retrospective cases series. Pediatric patients admitted to the Prof. Dr. Juan P. Garrahan Hospital of Buenos Aires City, Argentina, with isolation in blood cultures of P. putida were included, between August 2015 and August 2020. RESULTS: Sample consisting of 13 patients. Median age: 81 months (IQR 15-163). Ten of the patients were immunocompromised (77%), 11 (85%) had a central venous catheter, 2 (15%) received transfusions prior to the episode of bacteremia, and 6 (46%) had had an invasive procedure within the previous 30 days. Three patients (23%) presented bacteremia secondary to clinical focus and 10 (77%) had central venous catheter-associated bacteremia. All presented fever, 62% (8) evolved with sepsis and 15% (2) with septic shock. Two patients required admission to the intensive care unit (15%), and in 7 (54%) the central venous catheter was removed. None died. The median days of treatment was 14 (IQR 10-14). Resistance to carbapenems was 30%. CONCLUSION: All children had underlying comorbidities, most of them immunocompromised. Catheter-associated infection predominated. The sensitivity to antibiotics was variable. Given the emergence of multi-resistant strains, it is essential to know the local epidemiology.