Bloodstream infections in pediatric hematology/oncology patients: a single-center study in Wuhan

Area of Science:

• Pediatric Oncology
• Hematology
• Infectious Diseases

Background:

• Bloodstream infections (BSIs) pose significant risks for pediatric onco-hematological patients undergoing chemotherapy or hematopoietic stem cell transplantation (HSCT).
• These infections contribute to increased morbidity, prolonged hospitalization, and mortality in this vulnerable population.

Purpose of the Study:

• To retrospectively analyze the epidemiology and characteristics of BSIs in pediatric onco-hematological patients.
• To identify common pathogens and their antimicrobial susceptibility patterns.
• To understand the temporal distribution of BSIs across different phases of chemotherapy and HSCT.

Main Methods:

• Retrospective analysis of 202 BSIs in 145 pediatric patients with hematological malignancies, solid tumors, or non-malignant hematological diseases.
• Data collection included patient demographics, clinical features, pathogen identification, and antimicrobial susceptibility testing.
• Analysis focused on infection occurrence during induction, consolidation, and maintenance chemotherapy phases, as well as post-HSCT.

Main Results:

• Gram-positive bacteria were the most frequent causative agents (58.4%), followed by Gram-negative bacteria (41%).
• The induction chemotherapy phase showed the highest incidence of BSIs (46.5%), predominantly in neutropenic patients (88.3%).
• Staphylococcus epidermidis (19.8%), Staphylococcus hominis (16.3%), and Escherichia coli (8.4%) were the most prevalent pathogens.

Conclusions:

• BSIs represent a critical challenge in pediatric onco-hematology, particularly during intensive treatment phases.
• Tailored infection surveillance and management strategies are essential for mitigating the impact of BSIs.
• Understanding pathogen prevalence and susceptibility is key to optimizing antimicrobial therapy and improving patient outcomes.