title: Incidence of colonization and bloodstream infection with carbapenem-resistant Enterobacteriaceae in children receiving antineoplastic chemotherapy in Italy.
abstract: Few data are available on the incidence of carbapenemase-producing Enterobacteriaceae (CPE) infection or colonization in children receiving anticancer chemotherapy. We performed a nationwide survey among centers participating in the pediatric hematology-oncology cooperative study group (Associazione Italiana Ematologia Oncologia Pediatrica, AIEOP). During a 2-year observation period, we observed a threefold increase in the colonization rate, and a fourfold increase of bloodstream infection episodes, caused by CPE, with a 90-day mortality of 14%. This first nationwide Italian pediatric survey shows that the circulation of CPE strains in the pediatric hematology-oncology environment is increasing. Given the mortality rate, which is higher than for other bacterial strains, specific monitoring should be applied and the results should have implications for health-care practice in pediatric hematology-oncology.
authors.affiliation: a Azienda Ospedaliera Universitaria Meyer Children Hospital , Firenze.
authors.forename: Desiree
authors.initials: D
authors.lastname: Caselli
authors.affiliation: b Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata , Verona.
authors.forename: Simone
authors.initials: S
authors.lastname: Cesaro
authors.affiliation: c Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital , Torino.
authors.forename: Franca
authors.initials: F
authors.lastname: Fagioli
authors.affiliation: c Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital , Torino.
authors.forename: Francesca
authors.initials: F
authors.lastname: Carraro
authors.affiliation: d Pediatric Hematology Oncology, ARNAS Civico , Palermo.
authors.forename: Ottavio
authors.initials: O
authors.lastname: Ziino
authors.affiliation: e Pediatric Hematology Oncology , Trieste.
authors.forename: Giulio
authors.initials: G
authors.lastname: Zanazzo
authors.affiliation: f Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori , Milano.
authors.forename: Cristina
authors.initials: C
authors.lastname: Meazza
authors.affiliation: g Pediatric Hematology Oncology , Monza.
authors.forename: Antonella
authors.initials: A
authors.lastname: Colombini
authors.affiliation: h Istituto Giannina Gaslini , Torino , Italy.
authors.forename: Elio
authors.initials: E
authors.lastname: Castagnola
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D011446:Prospective Studies; D012189:Retrospective Studies; D016019:Survival Analysis; D018440:beta-Lactam Resistance; D047090:beta-Lactams / Q000494:pharmacology*
chemical_list: D000970:Antineoplastic Agents; D047090:beta-Lactams
keywords: Carbapenemase-producing Enterobacteriaceae; Klebsiella pneumoniae carbapenemase; cancer; children; immunosuppression