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Pseudomonas putida bacteremia in pediatric patients: A case series study
Micaela Picollo1, Daiana Karina Ferraro1, Guadalupe Pérez1
1Epidemiological Control and Infectious Disease Service, Hospital Nacional de Pediatría SAMIC Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina.
Introduction:
Bacteria of the genus Pseudomonas act as opportunistic pathogens. Pseudomonas putida has been considered a pathogen of low virulence and susceptible to multiple antibiotics, but in recent years resistant strains have emerged. The objective of this study is to describe the clinical characteristics, evolution and antibiotic resistance of P. putida bacteremia documented in pediatric hospitalized patients.
Methods:
Retrospective cases series. Pediatric patients admitted to the Prof. Dr. Juan P. Garrahan Hospital of Buenos Aires City, Argentina, with isolation in blood cultures of P. putida were included, between August 2015 and August 2020.
Results:
Sample consisting of 13 patients. Median age: 81 months (IQR 15-163). Ten of the patients were immunocompromised (77%), 11 (85%) had a central venous catheter, 2 (15%) received transfusions prior to the episode of bacteremia, and 6 (46%) had had an invasive procedure within the previous 30 days. Three patients (23%) presented bacteremia secondary to clinical focus and 10 (77%) had central venous catheter-associated bacteremia. All presented fever, 62% (8) evolved with sepsis and 15% (2) with septic shock. Two patients required admission to the intensive care unit (15%), and in 7 (54%) the central venous catheter was removed. None died. The median days of treatment was 14 (IQR 10-14). Resistance to carbapenems was 30%.
Conclusion:
All children had underlying comorbidities, most of them immunocompromised. Catheter-associated infection predominated. The sensitivity to antibiotics was variable. Given the emergence of multi-resistant strains, it is essential to know the local epidemiology.
Insights
Emerging antibiotic resistance in Pseudomonas putida bacteremia is a concern in hospitalized children. This study highlights clinical features and resistance patterns in pediatric patients, emphasizing the need for local epidemiological data.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Pediatric Infectious Diseases
Background:
- Pseudomonas putida, typically an opportunistic pathogen of low virulence, is increasingly associated with antibiotic-resistant infections.
- The emergence of multidrug-resistant strains necessitates a better understanding of P. putida bacteremia in vulnerable populations.
- Pediatric patients with underlying comorbidities are particularly susceptible to severe outcomes from bacterial infections.
Purpose of the Study:
- To characterize the clinical presentation, treatment course, and antibiotic resistance patterns of Pseudomonas putida bacteremia in hospitalized pediatric patients.
- To identify risk factors and common sources of P. putida bacteremia in a pediatric cohort.
- To inform clinical management and public health strategies regarding P. putida infections.
Main Methods:
- Retrospective case series including pediatric patients with P. putida isolated from blood cultures.
- Data collected from Prof. Dr. Juan P. Garrahan Hospital, Buenos Aires City, Argentina, between August 2015 and August 2020.
- Analysis of clinical characteristics, comorbidities, infection sources, treatment, and antibiotic susceptibility.
Main Results:
- A total of 13 pediatric patients were included, with a median age of 81 months.
- The majority of patients were immunocompromised (77%) and had central venous catheters (85%), with catheter-associated bacteremia being the predominant source (77%).
- Significant carbapenem resistance (30%) was observed, alongside variable antibiotic sensitivities. Two patients developed septic shock, and none died.
Conclusions:
- Pseudomonas putida bacteremia in hospitalized children often occurs in immunocompromised individuals with central venous catheters.
- The prevalence of multidrug-resistant strains, including carbapenem resistance, underscores the importance of local antimicrobial stewardship.
- Understanding the evolving epidemiology of P. putida is crucial for effective clinical management and infection control in pediatric settings.
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