Pathogens causing bloodstream infection after general surgery in infant and young children patients_Chinese Journal of Evidence-Based Medicine

Authors：

HE Chao , WANG Yuanfang , XU Huan , LI Mengjiao ,  XIE Yi

Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

XIE Yi, Email: xie_yi_77@163.com

Keywords：

Bloodstream infection; Pathogen; Resistance; General surgery

DOI：

10.7507/1672-2531.201707054

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the characteristics of the pathogens causing bloodstream infection after general surgery in infant and young children patients, and to provide the references for disease treatment and nosocomial infection control. Methods The clinical and laboratory examination data after general surgery in infant and young children patients, who were admitted to our hospital from January 2012 to March 2017, were retrospectively collected. The pathogens and drug resistance were analyzed by SPSS 18.0 software. Results In this study, 109 cases were included, and 117 strains of the pathogens were isolated, including 53 isolates (45.3%) of gram negative bacteria, 41 isolates (35.0%) of gram positive bacteria, and 23 isolates (19.7%) of fungi. Escherichia coli (16/117, 13.7%), Enterococcus faecium (13/117, 11.1%), Candida parapsilosis (12/117, 10.3%), Klebsiella pneumoniae (9/117, 7.7%) and Enterococcus faecalis (8/117, 6.8%) were the top 5 species. Strains producing extended-spectrum beta-lactamase accounted for 87.5% of E. coli (14/16) and 44.4% (4/9) of K. pneumoniae isolates. Both E. faecium and E. faecalis were susceptible to vancomycin. C. parapsilosis showed the susceptibility to the antifungal agents. Conclusion Gram negative bacteria are predominant pathogens causing bloodstream infection after general surgery in infant and young children patients, and infection caused by resistant isolates should be prevented and controlled.

Citation： HE Chao, WANG Yuanfang, XU Huan, LI Mengjiao, XIE Yi. Pathogens causing bloodstream infection after general surgery in infant and young children patients. Chinese Journal of Evidence-Based Medicine, 2017, 17(8): 903-906. doi: 10.7507/1672-2531.201707054 Copy

1.	de Mello MJ, de Albuquerque Mde F, Ximenes RA, et al. Factors associated with time to acquisition of bloodstream infection in a pediatric intensive care unit. Infect Control Hosp Epidemiol, 2010, 31(3): 249-255.
2.	Costello JM, Graham DA, Morrow DF, et al. Risk factors for central line-associated bloodstream infection in a pediatric cardiac intensive care unit. Pediatr Crit Care Med, 2009, 10(4): 453-459.
3.	Prowle JR, Echeverri JE, Ligabo EV, et al. Acquired bloodstream infection in the intensive care unit: incidence and attributable mortality. Crit Care, 2011, 15(2): R100.
4.	Mehl A, Asvold BO, Lydersen S, et al. Burden of bloodstream infection in an area of Mid-Norway 2002-2013: a prospective population-based observational study. BMC Infect Dis, 2017, 17(1): 205.
5.	Richards MJ, Edwards JR, Culver DH, et al. Nosocomial infections in medical intensive care units in the United States. national nosocomial infections surveillance system. Crit Care Med, 1999, 27(5): 887-892.
6.	Blot S, Cankurtaran M, Petrovic M, et al. Epidemiology and outcome of nosocomial bloodstream infection in elderly critically ill patients: a comparison between middle-aged, old, and very old patients. Crit Care Med, 2009, 37(5): 1634-1641.
7.	Marschall J, Mermel LA, Fakih M, et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol, 2014, 35(7): 753-771.
8.	Edwards JD, Herzig CT, Liu H, et al. Central line-associated blood stream infections in pediatric intensive care units: Longitudinal trends and compliance with bundle strategies. Am J Infect Control, 2015, 43(5): 489-493.
9.	Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control, 2008, 36(5): 309-332.
10.	Yogaraj JS, Elward AM, Fraser VJ. Rate, risk factors, and outcomes of nosocomial primary bloodstream infection in pediatric intensive care unit patients. Pediatrics, 2002, 110(3): 481-485.
11.	Ardura MI, Lewis J, Tansmore JL, et al. Central catheter-associated bloodstream infection reduction with ethanol lock prophylaxis in pediatric intestinal failure: broadening quality improvement initiatives from hospital to home. JAMA Pediatr, 2015, 169(4): 324-331.
12.	Cole CR, Frem JC, Schmotzer B, et al. The rate of bloodstream infection is high in infants with short bowel syndrome: relationship with small bowel bacterial overgrowth, enteral feeding, and inflammatory and immune responses. J Pediatr, 2010, 156(6): 941-947.
13.	Robinson JL, Casey LM, Huynh HQ, et al. Prospective cohort study of the outcome of and risk factors for intravascular catheter-related bloodstream infections in children with intestinal failure. JPEN J Parenter Enteral Nutr, 2014, 38(5): 625-630.
14.	马立斌, 柴琛, 曹农. 外科手术部位感染的危险因素及预防措施. 中国普外基础与临床杂志, 2014, 21(11): 1444-1447.
15.	郭林林, 谢伟, 魏红霞, 等. 儿外科监护室血流感染的病原菌分布及耐药性分析. 中国小儿急救医学, 2017, 24(4): 286-291.
16.	吴晓明, 钟华敏, 关小珊, 等. 婴幼儿血培养分离细菌及其耐药性分析. 国际检验医学杂, 2016, 37(5): 591-593.
17.	Singhi S, Ray P, Mathew JL, et al. Nosocomial bloodstream infection in a pediatric intensive care unit. Indian J Pediatr, 2008, 75(1): 25-30.
18.	Lupetti A, Tavanti A, Davini P, et al. Horizontal transmission of Candida parapsilosis candidemia in a neonatal intensive care unit. J Clin Microbiol, 2002, 40(7): 2363-2369.
19.	Wylie MC, Graham DA, Potter-Bynoe G, et al. Risk factors for central line-associated bloodstream infection in pediatric intensive care units. Infect Control Hosp Epidemiol, 2010, 31(10): 1049-1056.
20.	Ahmed SS, McCaskey MS, Bringman S, et al. Catheter-associated bloodstream infection in the pediatric intensive care unit: a multidisciplinary approach. Pediatr Crit Care Med, 2012, 13(2): e69-72.
21.	Devrim I, Yasar N, Isguder R, et al. Clinical impact and cost-effectiveness of a central line bundle including split-septum and single-use prefilled flushing devices on central line-associated bloodstream infection rates in a pediatric intensive care unit. Am J Infect Control, 2016, 44(8): e125-128.
22.	Al-Hasan MN, Huskins WC, Lahr BD, et al. Epidemiology and outcome of Gram-negative bloodstream infection in children: a population-based study. Epidemiol Infect, 2011, 139(5): 791-796.
23.	Dotis J, Prasad PA, Zaoutis T, et al. Epidemiology, risk factors and outcome of Candida parapsilosis bloodstream infection in children. Pediatr Infect Dis J, 2012, 31(6): 557-560.

1. de Mello MJ, de Albuquerque Mde F, Ximenes RA, et al. Factors associated with time to acquisition of bloodstream infection in a pediatric intensive care unit. Infect Control Hosp Epidemiol, 2010, 31(3): 249-255.
2. Costello JM, Graham DA, Morrow DF, et al. Risk factors for central line-associated bloodstream infection in a pediatric cardiac intensive care unit. Pediatr Crit Care Med, 2009, 10(4): 453-459.
3. Prowle JR, Echeverri JE, Ligabo EV, et al. Acquired bloodstream infection in the intensive care unit: incidence and attributable mortality. Crit Care, 2011, 15(2): R100.
4. Mehl A, Asvold BO, Lydersen S, et al. Burden of bloodstream infection in an area of Mid-Norway 2002-2013: a prospective population-based observational study. BMC Infect Dis, 2017, 17(1): 205.
5. Richards MJ, Edwards JR, Culver DH, et al. Nosocomial infections in medical intensive care units in the United States. national nosocomial infections surveillance system. Crit Care Med, 1999, 27(5): 887-892.
6. Blot S, Cankurtaran M, Petrovic M, et al. Epidemiology and outcome of nosocomial bloodstream infection in elderly critically ill patients: a comparison between middle-aged, old, and very old patients. Crit Care Med, 2009, 37(5): 1634-1641.
7. Marschall J, Mermel LA, Fakih M, et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol, 2014, 35(7): 753-771.
8. Edwards JD, Herzig CT, Liu H, et al. Central line-associated blood stream infections in pediatric intensive care units: Longitudinal trends and compliance with bundle strategies. Am J Infect Control, 2015, 43(5): 489-493.
9. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control, 2008, 36(5): 309-332.
10. Yogaraj JS, Elward AM, Fraser VJ. Rate, risk factors, and outcomes of nosocomial primary bloodstream infection in pediatric intensive care unit patients. Pediatrics, 2002, 110(3): 481-485.
11. Ardura MI, Lewis J, Tansmore JL, et al. Central catheter-associated bloodstream infection reduction with ethanol lock prophylaxis in pediatric intestinal failure: broadening quality improvement initiatives from hospital to home. JAMA Pediatr, 2015, 169(4): 324-331.
12. Cole CR, Frem JC, Schmotzer B, et al. The rate of bloodstream infection is high in infants with short bowel syndrome: relationship with small bowel bacterial overgrowth, enteral feeding, and inflammatory and immune responses. J Pediatr, 2010, 156(6): 941-947.
13. Robinson JL, Casey LM, Huynh HQ, et al. Prospective cohort study of the outcome of and risk factors for intravascular catheter-related bloodstream infections in children with intestinal failure. JPEN J Parenter Enteral Nutr, 2014, 38(5): 625-630.
14. 马立斌, 柴琛, 曹农. 外科手术部位感染的危险因素及预防措施. 中国普外基础与临床杂志, 2014, 21(11): 1444-1447.
15. 郭林林, 谢伟, 魏红霞, 等. 儿外科监护室血流感染的病原菌分布及耐药性分析. 中国小儿急救医学, 2017, 24(4): 286-291.
16. 吴晓明, 钟华敏, 关小珊, 等. 婴幼儿血培养分离细菌及其耐药性分析. 国际检验医学杂, 2016, 37(5): 591-593.
17. Singhi S, Ray P, Mathew JL, et al. Nosocomial bloodstream infection in a pediatric intensive care unit. Indian J Pediatr, 2008, 75(1): 25-30.
18. Lupetti A, Tavanti A, Davini P, et al. Horizontal transmission of Candida parapsilosis candidemia in a neonatal intensive care unit. J Clin Microbiol, 2002, 40(7): 2363-2369.
19. Wylie MC, Graham DA, Potter-Bynoe G, et al. Risk factors for central line-associated bloodstream infection in pediatric intensive care units. Infect Control Hosp Epidemiol, 2010, 31(10): 1049-1056.
20. Ahmed SS, McCaskey MS, Bringman S, et al. Catheter-associated bloodstream infection in the pediatric intensive care unit: a multidisciplinary approach. Pediatr Crit Care Med, 2012, 13(2): e69-72.
21. Devrim I, Yasar N, Isguder R, et al. Clinical impact and cost-effectiveness of a central line bundle including split-septum and single-use prefilled flushing devices on central line-associated bloodstream infection rates in a pediatric intensive care unit. Am J Infect Control, 2016, 44(8): e125-128.
22. Al-Hasan MN, Huskins WC, Lahr BD, et al. Epidemiology and outcome of Gram-negative bloodstream infection in children: a population-based study. Epidemiol Infect, 2011, 139(5): 791-796.
23. Dotis J, Prasad PA, Zaoutis T, et al. Epidemiology, risk factors and outcome of Candida parapsilosis bloodstream infection in children. Pediatr Infect Dis J, 2012, 31(6): 557-560.

Chinese Journal of Evidence-Based Medicine

Pathogens causing bloodstream infection after general surgery in infant and young children patients

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