scholarly journals Catheter‐related blood stream infection caused by Mycobacterium chelonae in a child with myeloid leukemia associated with Down syndrome

2020 ◽  
Author(s):  
Tomoko Fujikawa ◽  
Suguru Uemura ◽  
Yuya Aoto ◽  
Yoshinori Nambu ◽  
China Nagano ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Myeloid Leukemia ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Mycobacterium Chelonae

scholarly journals Cumulative Incidence of Blood Stream Infections during Acute Myeloid Leukemia Treatment in the Netherlands: A 15-Year Overview

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 2685-2685
Author(s):  
Emily Risa Schwartz ◽  
Kim Klein ◽  
Valerie de Haas ◽  
Birgit Lissenberg-Witte ◽  
Lynn Ball ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Myeloid Leukemia ◽  
Cumulative Incidence ◽  
Myeloid Leukemia ◽  
De Novo ◽  
Conflicts Of Interest ◽  
Blood Stream Infection ◽  
Treatment Protocol ◽  
Blood Stream ◽  
Acute Myeloid

Abstract Background/Objectives Despite the use of antibiotic prophylaxis, bacterial infections remain the leading cause of treatment-related morbidity in children with acute myeloid leukemia (AML). The objectives of this study were to: 1) evaluate the cumulative incidence of blood stream infection (BSI) during treatment according to the last three consecutive protocols of the Dutch Childhood Oncology Group (DCOG); 2) determine the most common bacterial pathogens; and 3) determine risk factors. Design/Methods A retrospective chart review was performed on 246 patients (DCOG treatment protocols ANLL-97/AML-12 n=119, AML-15 n=60, DB-AML01 n=67) diagnosed with de novo AML (APL and Down syndrome excluded) between 1998-2013. All patients received prophylaxis with co-trimoxazole. From AML-15 onwards, patients also received prophylactic fluoroquinolones. BSIs were defined as a positive blood culture confirmed by the hospital's microbiologist. The cumulative incidence of BSIs was determined using competing risk analysis with death, switch to another protocol, or stem cell transplantation as competing events. Age, sex, BMI, white blood cell count (WBC) at diagnosis, cytogenetics, and treatment protocol were evaluated as risk factors. Results Median age was 6.4 years [range 17.4], 58% were male. The cumulative incidence of BSIs was 78.2%. The most common pathogens were Staphylococcus epidermidis (15.6%), Streptococcus mitis (14.9%) and other Staphylococci (11.6%). ANLL-97/AML-12 (78%) and AML-15 (72%) showed a lower BSI incidence than DB-AML01 (84%; hazard ratio(HR)s 0.69 [0.50-0.97], p=0.033 and 0.59 [0.40-0.89], p=0.012, respectively). WBC >20x109/l was associated with a lower risk of infections (HR 0.72 [0.54-0.96], p=0.026). The other risk factors were not statistically significant. Conclusion The most recent DCOG protocol was associated with the highest incidence of BSIs, probably as a result of the high intensity of this protocol. Furthermore, the use of prophylactic antibiotics with gram-negative coverage may have resulted in a relatively higher incidence in gram-positive BSI. The high incidence stresses the urge to improve anti-infective supportive care measures. Disclosures No relevant conflicts of interest to declare.

Comparison of Complications Related to Peripherally Inserted Central Catheters, Infusion Ports, and Hickman Catheters in Acute Myeloid Leukemia Patients

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4288-4288
Author(s):  
Mohammad O. Khalil ◽  
Namali Pierson ◽  
Hossein Maymani ◽  
Jennifer L. Holter ◽  
Mohamad Ali Cherry
Keyword(s):  
Acute Myeloid Leukemia ◽  
Platelet Count ◽  
Myeloid Leukemia ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Cell Transplant ◽  
Age Group ◽  
Different Types ◽  
Oklahoma Health ◽  
Acute Myeloid

Abstract Abstract 4288 Background: Intravenous catheters are widely used in acute myeloid leukemia (AML) patients. Complications associated with these catheters are frequently encountered and contribute to morbidity, mortality, and increased cost of treatment. Studies exploring and comparing complications in the different types of catheters in this unique patient population are lacking. We retrospectively studied infectious and thrombotic catheter-related complications in AML patients treated at the largest tertiary referral center for AML in Oklahoma. Methods: AML patients above the age of 18 who were referred to The University of Oklahoma Health Sciences Center from January, 2000 to June, 2012 were identified and medical records were reviewed. Patients were stratified according to type of first catheter inserted (peripherally inserted central catheter (PICC), infusion port (IP), or Hickman). First catheter-related blood stream infection and deep venous thrombosis (DVT) events were reported (subsequent catheter-related complications were not included). Statistical analysis was performed using SAS 9.2 software (SAS Institute Inc). Fisher exact test was used to compare patients with different types of catheters. Results: 195 patients with AML were identified; of which 125 were included in the analysis (Patients referred for stem cell transplant (SCT) were excluded if not treated with prior chemotherapy at our institution). Median age at diagnosis was 51 years. 87 (70%) were males and 38 (30%) were females. 97 (78%) were White, 11 (9%) Native Americans, and 10 (8%) African Americans. 73 (58%) had PICC, 34 (27%) had Hickman, and 17 (14%) had IP. Blood stream infection occurred in 34% of all patients. Blood stream infection rates in each group were 32% in patients with PICC, 47% with IP, and 31% with Hickman (p=0.47). When divided by age group, infections occurred in 41% of patients 55 years of age or older and in 29% of those <55 years (p=0.19). Gram-positive cocci accounted for 57% and Gram-negative rods for 30% of all infections. DVT occurred in 14% of all cases. DVT rates in each group were 22% in patients with PICC, 6% with IP, and none with Hickman (p=0.002). When divided by age group, thrombosis rates were 9% in patients 55 years of age or older and 17% in those <55 years (p=0.29). 39% of patients with platelet count >20,000/microL at the time of event had DVT compared to only 8% of those with platelet count <20,000/microL (p=0.0005). Conclusion: Among AML patients referred to our institution, PICCs were associated with significantly higher rate of DVT compared to IPs and Hickmans. Platelet count >20,000/microL was also associated with significantly higher rate of thrombosis. There was no difference in blood stream infections across the different catheter types. Disclosures: No relevant conflicts of interest to declare.

Cooperativity between miR-125b and Gata1 s in the pathogenesis of Down syndrome-associated myeloid leukemia

2019 ◽  
Author(s):  
O Alejo-Valle ◽  
M Labuhn ◽  
E Emmrich ◽  
M Ng ◽  
D Heckl ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Myeloid Leukemia

Healthcare associated infections caused by non-fermenting Gram negative rods (NFGNR): six years of experience of a tertiary hospital

2013 ◽  
Vol 7 (2) ◽  
pp. 06-12
Author(s):  
Zahidul Hasan ◽  
Md. Kamrul Islam ◽  
Arifa Hossain
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Tertiary Hospital ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Gram Negative ◽  
Acinetobacter Spp ◽  
Tract Infections ◽  
Healthcare Associated

Recently non-fermenting Gram negative rods (NFGNR) are playing an important role in healthcare associated infections. This observational study in a tertiary care hospital of Dhaka city conducted during 01August 2007 to 30 June 2013 found that 34.8% isolated organisms from patients with healthcare associated infections were NFGNR. Majority (74.3 %) of these infections were occurring inside critical care areas. Pseudomonas and Acinetobacter together constituted 79.6% of the total NFGNR whereas Burkholderia cephacia complex (15.4%), Stenotrophomonas (4.3%) and Chryseobacterium species (0.7%) combined constituted remaining 20.4%. Out of total NFGNRs, Pseudomonas was responsible for highest number of catheter associated urinary tract infections (55.6%), ventilator associated pneumonia (46.3%), respiratory tract infection (65.8%) and surgical site infection (70.6%). Blood stream infection was predominantly caused by Burkholderia cephacia complex (33.5%) and Acinetobacter spp. (39.5%). Other than colistin most of the organisms were resistant to antibiotics commonly recommended for NFGNR.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19326 Bangladesh J Med Microbiol 2013; 07(02): 6-12

scholarly journals Is it cost effective to use a 2% chlorhexidine wipes bath to reduce central-line associated blood stream infection? A quasi-experimental study

2021 ◽  
Vol 25 (1) ◽  
pp. 101538
Author(s):  
Diego Feriani ◽  
Ercilia Evangelista Souza ◽  
Larissa Gordilho Mutti Carvalho ◽  
Aline Santos Ibanes ◽  
Eliana Vasconcelos ◽  
...  
Keyword(s):  
Experimental Study ◽  
Blood Stream Infection ◽  
Cost Effective ◽  
Blood Stream ◽  
Central Line ◽  
Quasi Experimental

scholarly journals 250. Blood Stream Infections (BSI) in Pediatric Neuroblastoma High Risk: Emphasis on Viridans Group Streptococci (VGS) Bacteremia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S124-S125
Author(s):  
Muayad Alali ◽  
Joseph Hageman
Keyword(s):  
High Risk ◽  
Solid Tumors ◽  
Induction Chemotherapy ◽  
Blood Stream Infection ◽  
Lymphoblastic Leukemia ◽  
Blood Stream ◽  
High Risk Group ◽  
Related Complication ◽  
High Risk Factors ◽  
Viridans Group Streptococci

Abstract Background Febrile neutropenia’s (FN) literature has focused on acute leukemia and undergoing allogeneic stem cell transplantation (SCT) as high risk factors for microbiological documented infection (MDI) and blood stream infection (BSI). Comprehensive studies on in pediatric Neuroblastoma high risk (NB-HR) who receive highly myelosuppressive therapy are lacking. Methods We conducted a retrospective medical record review of pediatric patients who received any oncology care at UCM Comer Children’s Hospitals.with a diagnosis of FN who had at least 1 blood culture obtained and one of the following underlying diagnoses (AML, lymphoblastic leukemia ALL), NB-HR, and other solid tumors (ST). SCT patients were excluded from study. We reviewed pathogens isolated from blood cultures (BCx) and determined whether they were pathogens or contaminants using IDSA guidelines. Comparative analyses of BSI rates between NB-HR and other underlying diagnoses were done. Results A total of 560 FN episodes (FNEs) were identified in 230 patients. FNEs occurred in NB-HR were 102 in 77 patients. Fifty-seven percent of patients developed one or more BSI or MDI during induction chemotherapy. The mean age was 11.0 (SD=6.5) years. True BSI occurred in 138 (24.6%) of FN episodes. The organisms that were most frequently isolated from were viridans group streptococci (VGS) (25%). The highest rate of BSI occurred among FNEs with AML (44/115, 37%) followed by NB-HR 26/110 (25%) Table1. Overall BSI rate in NB-HR group is higher than other solid tumors (25 vs 17%, P=0.03). In subset analysis, VGS bacteremia was highest among FNEs with AML and NB-HR compared with ALL (8.7 and 8.8 % vs 6%) P&lt; 0.04 and P=0.02 respectively. Notably, the gram positive/ gram negative (GP/GN ratio) in NB-HR compared with ST was significantly higher (OR =2.26, CI 95% 1.5–7.8, P&lt; 0.01), this was likely due to a higher VGS rate (8.8% vs 2%, OR=4.2, P &lt; 0.01). Rate of GN-BSI are same in each of ALL,HR-NB and ST. Conclusion Our large Neuroblastoma cohort showed that NB-HR during induction chemotherapy are higher risk for VGS bacteremia, compared with other solid tumors. Further prospective studies are needed to investigate infection related complication in this high risk group and possible improved morbidity and mortality. Disclosures All Authors: No reported disclosures

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