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Published on: September 30, 2017
Raoultella ornithinolytica Infection in the Pediatric Population: A Retrospective Study
Dan-Dan Pi1,2, Fang Zhou1,2, Ke Bai1,2
1Intensive Care Unit, Children's Hospital of Chongqing Medical University, Chongqing, China.
Insights
Raoultella ornithinolytica infections in children are rising. This study highlights key clinical features, risk factors like congenital malformations and immune deficiencies, and effective antibiotic treatments, emphasizing poor prognosis in sepsis cases.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Bacterial Pathogenesis
Background:
- Raoultella ornithinolytica is an emerging pathogen causing pediatric infections.
- Understanding its clinical spectrum and susceptibility is crucial for effective management.
Purpose of the Study:
- To investigate the clinical characteristics of Raoultella ornithinolytica infections in children.
- To analyze drug susceptibility patterns for guiding treatment decisions.
Main Methods:
- Retrospective analysis of five pediatric cases from a single hospital.
- Systematic literature review of nine additional cases from multiple databases.
- Analysis of clinical features, comorbidities, and antimicrobial susceptibility.
Main Results:
- Fever is the predominant symptom; neonates may present with dyspnea and hypoxemia.
- Risk factors include congenital malformations, neoplastic diseases, immune deficiencies, and invasive procedures.
- Bloodstream infection is the primary route; skin flushing and erythema can be early indicators in neonates.
- Third-generation cephalosporins, carbapenems, quinolones, and aminoglycosides show favorable susceptibility.
Conclusions:
- Raoultella ornithinolytica poses a significant threat to pediatric populations, particularly those with underlying vulnerabilities.
- Early recognition of specific symptoms and prompt administration of appropriate antibiotics are vital.
- Sepsis cases associated with this pathogen often have a poor prognosis, necessitating further research and improved therapeutic strategies.
Abstract:
Raoultella ornithinolytica is a pathogen causing an increasing number of pediatric infections. The objective of this study was to investigate the clinical characteristics of R. ornithinolytica infections in children. As a retrospective analysis, clinical features and drug susceptibility data of the five cases were analyzed and related literature was reviewed. A total of 14 cases (eight females, six males) were analyzed: nine cases were retrieved from PubMed, Web of Science, and three domestic databases; five cases occurred in our hospital. The primary diseases of the older children were mainly of neoplastic and immune origin, while cases of infants and young children were mostly complicated by congenital malformation. Fever was the main symptom, and neonatal infection was mainly manifested by dyspnea and hypoxemia, with multiple skin flushes, systemic erythema, and leukocytosis. Of the 14 cases, six were ventilator-assisted, five had indwelling urethral catheters, three had surgical treatment or chemotherapy, and one had multiple rounds of continuous renal replacement therapy (CRRT). Blood infection is the main route of R. ornithinolytica infection in children. Skin flushing and systemic erythema might be positive clues for newborn infection. Patients with multiple congenital abnormalities are susceptible to infection. Tumors, immune deficiency, and invasive operations increase the risk of infection. Blood culture was the main method of disease identification. Based on the drug susceptibility results, the preferred antibiotics are third generations of cephalosporins, carbapenems, quinolone, and aminoglycoside. Lastly, patients with sepsis mostly have poor prognosis.
