新诊断患有恶性瘤的儿童的格拉姆阴性肠道殖民:微生物学,抗菌素耐药性模式和临床影响
Ali Amanati1,2, Asiyeh Dezhkam3, Farzaneh Safari3
1Clinical Research Development Center, Amir Oncology Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Gut pathogens
|February 22, 2026
概括
儿童癌症患者的肠道殖民率高,有耐卡巴胺的肠道细菌 (CP-CRE) 和扩展光谱β-乳糖酶生成 (ESBL) 细菌. 监测和控制对于预防这种脆弱人群感染至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 在瘤学瘤学.
- 微生物学 微生物学
背景情况:
- 耐卡巴胺肠道细菌 (CRE) 由于抗生素耐药性较高,因此存在重大治疗挑战.
- 这项研究侧重于小儿癌症患者的CP-CRE和ESBL产生格兰阴性细菌 (GNB) 的肠道殖民率.
- 它还评估了抗生素易感性和潜在的传染性并发症.
研究的目的:
- 在儿童癌症患者中调查CP-CRE和ESBL产生GNB的肠道殖民率.
- 为了确定这些耐药细菌的抗生素敏感性概况.
- 在这个患者群体中检查传染性并发症.
主要方法:
- 一个瘤医院的前性队列研究.
- 在三个时间点收集的便样本,以评估社区和医院获得的殖民.
- 抗菌敏感性测试,表型ESBL查和PCR检测耐药基因.
主要成果:
- 包括81名儿科患者;70%的社区获得了GNB殖民.
- 在58%的样本中检测到产生ESBL的GNB;在14.6%的样本中检测到CP-CRE.
- 胆固醇,阿米卡辛和卡巴胺在体外活性最高.
结论:
- 由于CP-CRE殖民的高发生率,迫切需要采取监测和控制措施.
- 这对于新诊断的儿科癌症患者在瘤学环境中尤其重要.
- 防止高度耐药细菌的传播对于患者的治疗结果至关重要.
相关概念视频
Introduction to the Human Microbiota
101
Microorganisms colonize various regions of the human body, including the mouth, nasal passages, throat, stomach, intestines, urogenital tract, and skin. The total number of microbial cells is estimated to range from 10¹³ to 10¹⁴—comparable to, or exceeding, the number of human somatic cells. This host–microbiome relationship has led to the conceptualization of humans as supraorganisms, wherein microbial communities perform vital roles in development, immunity,...
101
Development of Human Microbiota
44
The human microbiota begins developing at birth and undergoes continual change as we age. Infancy marks a critical period of microbial sensitivity, offering a “window of opportunity” during which beneficial microbes help mature the immune system. By age three, children typically develop a more stable and diverse microbial community. Newborns acquire microbes from their immediate environment; vaginal delivery favors maternal vaginal microbes, while cesarean births favor microbes from...
44
Development of the Oral Microbiota
41
The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
41
Microbiota of the Stomach and Small Intestine
60
The human gastrointestinal (GI) tract is characterized by distinct physicochemical conditions that shape its microbial communities. Among these, the stomach presents a particularly challenging environment for microbial colonization due to its highly acidic pH, ranging from 1 to 3. This extreme acidity effectively limits microbial density. However, certain acid-tolerant microorganisms are capable of surviving in this niche. Notably, Helicobacter pylori can colonize the gastric mucosa,...
60
Mechanism of Antibiotic Resistance in MRSA
135
Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and...
135
Clinical Significance of Antibiotic Resistance
55
Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within...
55


