Journal of Clinical Medicine (Jul 2024)
Infections with <i>Klebsiella pneumoniae</i> in Children Undergoing Anticancer Therapy or Hematopoietic Cell Transplantation: A Multicenter Nationwide Study
- Alicja Sękowska,
- Krzysztof Czyżewski,
- Kamila Jaremek,
- Patrycja Zalas-Więcek,
- Olga Zając-Spychała,
- Jacek Wachowiak,
- Anna Szmydki-Baran,
- Łukasz Hutnik,
- Agnieszka Gietka,
- Olga Gryniewicz-Kwiatkowska,
- Bożenna Dembowska-Bagińska,
- Katarzyna Semczuk,
- Katarzyna Dzierżanowska-Fangrat,
- Wojciech Czogała,
- Walentyna Balwierz,
- Iwona Żak,
- Renata Tomaszewska,
- Tomasz Szczepański,
- Ewa Bień,
- Ninela Irga-Jaworska,
- Katarzyna Machnik,
- Justyna Urbańska-Rakus,
- Sonia Pająk,
- Marcin Płonowski,
- Maryna Krawczuk-Rybak,
- Aleksandra Królak,
- Tomasz Ociepa,
- Tomasz Urasiński,
- Paweł Wawryków,
- Jarosław Peregud-Pogorzelski,
- Tomasz Brzeski,
- Katarzyna Mycko,
- Hanna Mańko-Glińska,
- Wanda Badowska,
- Agnieszka Urbanek-Dądela,
- Grażyna Karolczyk,
- Weronika Stolpa,
- Katarzyna Skowron-Kandzia,
- Agnieszka Mizia-Malarz,
- Filip Pierlejewski,
- Wojciech Młynarski,
- Jakub Musiał,
- Radosław Chaber,
- Joanna Zawitkowska,
- Agnieszka Zaucha-Prażmo,
- Katarzyna Drabko,
- Jolanta Goździk,
- Jowita Frączkiewicz,
- Małgorzata Salamonowicz-Bodzioch,
- Krzysztof Kałwak,
- Jan Styczyński
Affiliations
- Alicja Sękowska
- Microbiology Department, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-094 Bydgoszcz, Poland
- Krzysztof Czyżewski
- Department of Pediatrics, Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University in Torun, 85-094 Bydgoszcz, Poland
- Kamila Jaremek
- Department of Pediatrics, Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University in Torun, 85-094 Bydgoszcz, Poland
- Patrycja Zalas-Więcek
- Microbiology Department, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-094 Bydgoszcz, Poland
- Olga Zając-Spychała
- Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, 61-701 Poznan, Poland
- Jacek Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, 61-701 Poznan, Poland
- Anna Szmydki-Baran
- Department of Oncology, Pediatric Hematology, Clinical Transplantation and Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland
- Łukasz Hutnik
- Department of Oncology, Pediatric Hematology, Clinical Transplantation and Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland
- Agnieszka Gietka
- Department of Oncology, Children’s Memorial Health Institute, 04-730 Warsaw, Poland
- Olga Gryniewicz-Kwiatkowska
- Department of Oncology, Children’s Memorial Health Institute, 04-730 Warsaw, Poland
- Bożenna Dembowska-Bagińska
- Department of Oncology, Children’s Memorial Health Institute, 04-730 Warsaw, Poland
- Katarzyna Semczuk
- Department of Clinical Microbiology and Immunology, Children’s Memorial Health Institute, 04-730 Warsaw, Poland
- Katarzyna Dzierżanowska-Fangrat
- Department of Clinical Microbiology and Immunology, Children’s Memorial Health Institute, 04-730 Warsaw, Poland
- Wojciech Czogała
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 31-008 Krakow, Poland
- Walentyna Balwierz
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 31-008 Krakow, Poland
- Iwona Żak
- Department of Microbiology, University Children’s Hospital, 30-663 Krakow, Poland
- Renata Tomaszewska
- Department of Pediatric Hematology and Oncology, Silesian Medical University, 41-808 Zabrze, Poland
- Tomasz Szczepański
- Department of Pediatric Hematology and Oncology, Silesian Medical University, 41-808 Zabrze, Poland
- Ewa Bień
- Department of Pediatrics, Hematology and Oncology, Medical University, 80-210 Gdansk, Poland
- Ninela Irga-Jaworska
- Department of Pediatrics, Hematology and Oncology, Medical University, 80-210 Gdansk, Poland
- Katarzyna Machnik
- Division of Pediatric Hematology and Oncology, Chorzow City Hospital, 41-500 Chorzow, Poland
- Justyna Urbańska-Rakus
- Division of Pediatric Hematology and Oncology, Chorzow City Hospital, 41-500 Chorzow, Poland
- Sonia Pająk
- Division of Pediatric Hematology and Oncology, Chorzow City Hospital, 41-500 Chorzow, Poland
- Marcin Płonowski
- Department of Pediatric Oncology and Hematology, Medical University, 15-089 Bialystok, Poland
- Maryna Krawczuk-Rybak
- Department of Pediatric Oncology and Hematology, Medical University, 15-089 Bialystok, Poland
- Aleksandra Królak
- Department of Pediatrics, Pediatric Hematooncology and Gastroenterology, Pomeranian Medical University, 70-204 Szczecin, Poland
- Tomasz Ociepa
- Department of Pediatrics, Pediatric Hematooncology and Gastroenterology, Pomeranian Medical University, 70-204 Szczecin, Poland
- Tomasz Urasiński
- Department of Pediatrics, Pediatric Hematooncology and Gastroenterology, Pomeranian Medical University, 70-204 Szczecin, Poland
- Paweł Wawryków
- Department of Pediatrics, Pediatric Oncology and Immunology, Pomeranian Medical University, 70-204 Szczecin, Poland
- Jarosław Peregud-Pogorzelski
- Department of Pediatrics, Pediatric Oncology and Immunology, Pomeranian Medical University, 70-204 Szczecin, Poland
- Tomasz Brzeski
- Department of Clinical Pediatrics University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland
- Katarzyna Mycko
- Department of Clinical Pediatrics University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland
- Hanna Mańko-Glińska
- Department of Clinical Pediatrics University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland
- Wanda Badowska
- Department of Clinical Pediatrics University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland
- Agnieszka Urbanek-Dądela
- Division of Pediatric Hematology and Oncology, Children Hospital, 25-736 Kielce, Poland
- Grażyna Karolczyk
- Division of Pediatric Hematology and Oncology, Children Hospital, 25-736 Kielce, Poland
- Weronika Stolpa
- Division of Pediatric Oncology, Hematology and Chemotherapy, Department of Pediatric, Silesian Medical University, 40-055 Katowice, Poland
- Katarzyna Skowron-Kandzia
- Division of Pediatric Oncology, Hematology and Chemotherapy, Department of Pediatric, Silesian Medical University, 40-055 Katowice, Poland
- Agnieszka Mizia-Malarz
- Division of Pediatric Oncology, Hematology and Chemotherapy, Department of Pediatric, Silesian Medical University, 40-055 Katowice, Poland
- Filip Pierlejewski
- Department of Pediatrics, Hematology and Oncology, Medical University, 90-419 Lodz, Poland
- Wojciech Młynarski
- Department of Pediatrics, Hematology and Oncology, Medical University, 90-419 Lodz, Poland
- Jakub Musiał
- Department of Pediatric Oncohematology, Medical Faculty University of Rzeszow, Clinical Provincial Hospital No. 2, 35-301 Rzeszow, Poland
- Radosław Chaber
- Department of Pediatric Oncohematology, Medical Faculty University of Rzeszow, Clinical Provincial Hospital No. 2, 35-301 Rzeszow, Poland
- Joanna Zawitkowska
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-059 Lublin, Poland
- Agnieszka Zaucha-Prażmo
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-059 Lublin, Poland
- Katarzyna Drabko
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-059 Lublin, Poland
- Jolanta Goździk
- Stem Cell Transplant Center, University Children’s Hospital, Department of Clinical Immunology and Transplantology, Jagiellonian University Collegium Medicum, 31-008 Krakow, Poland
- Jowita Frączkiewicz
- Department of Pediatric Hematology, Oncology and BMT, Wroclaw Medical University, 50-367 Wrocław, Poland
- Małgorzata Salamonowicz-Bodzioch
- Department of Pediatric Hematology, Oncology and BMT, Wroclaw Medical University, 50-367 Wrocław, Poland
- Krzysztof Kałwak
- Department of Pediatric Hematology, Oncology and BMT, Wroclaw Medical University, 50-367 Wrocław, Poland
- Jan Styczyński
- Department of Pediatrics, Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University in Torun, 85-094 Bydgoszcz, Poland
- DOI
- https://doi.org/10.3390/jcm13144078
- Journal volume & issue
-
Vol. 13,
no. 14
p. 4078
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 K. pneumoniae strains were extended-spectrum β-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.
Keywords
