Haematologica (Sep 2010)

Multidrug resistant Pseudomonas aeruginosa infection in children undergoing chemotherapy and hematopoietic stem cell transplantation

  • Désirée Caselli,
  • Simone Cesaro,
  • Ottavio Ziino,
  • Giulio Zanazzo,
  • Rosaria Manicone,
  • Susanna Livadiotti,
  • Monica Cellini,
  • Stefano Frenos,
  • Giuseppe M. Milano,
  • Barbara Cappelli,
  • Maria Licciardello,
  • Chiara Beretta,
  • Maurizio Aricò,
  • Elio Castagnola

DOI
https://doi.org/10.3324/haematol.2009.020867
Journal volume & issue
Vol. 95, no. 9

Abstract

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Pseudomonas aeruginosa is one leading gram-negative organism associated with nosocomial infections. Bacteremia is life-threatening in the immunocompromised host. Increasing frequency of multi-drug-resistant (MDRPA) strains is concerning. We started a retrospective survey in the pediatric hematology oncology Italian network. Between 2000 and 2008, 127 patients with Pseudomonas aeruginosa bacteremia were reported from 12 centers; 31.4% of isolates were MDRPA. Death within 30 days of a positive blood culture occurred in 19.6% (25/127) of total patients; in patients with MDRPA infection it occurred in 35.8% (14/39). In the multivariate analysis, only MDRPA had significant association with infection-related death. This is the largest series of Pseudomonas aeruginosa bacteremia cases from pediatric hematology oncology centers. Monitoring local bacterial isolates epidemiology is mandatory and will allow empiric antibiotic therapy to be tailored to reduce fatalities.