title: [Nosocomial septicemia in the early stage after stem cell transplantation in children with major β-thalassemia].
abstract: OBJECTIVE
  To explore the clinical characteristics of nosocomial septicemia in the early stage after hematopoietic stem cell transplantation (HSCT) in children with major β-thalassemia.
  
  
  METHODS
  The clinical data were retrospectively analyzed of 55 consecutive children with major β-thalassemia who developed septicemia early after HSCT between January, 2011 and June, 2016.
  
  
  RESULTS
  Among the total of 416 consecutive children with major β-thalassemia undergoing allogeneic HSCT, the incidence of nosocomial infection early after transplantation was 77.16% (321/416), and 55 (17.13%) children showed positive findings in blood culture test. The infections occurred most commonly in the oral cavity (65.5%), followed by the respiratory tract, intestinal tract and skin. Gram-negative bacteria, including Escherichia coli (27.3%), Klebsiella pneumoniae (21.8%) and Pseudomonas aeruginosa (9.1%), were the most common causes of infections. Fungal (Candida tropicalis) infection caused septicemia in 1 case. Of all the pathogens, extended-spectrum β-lactamase (ESBL)-producing bacteria were found in 6 cases, methicillin-resistant Staphylococcus aureus (MRSA) in 2 cases, and multidrug-resistant (MDR) bacteria in 2 cases.
  
  
  CONCLUSIONS
  Gram-negative bacteria are the major pathogens causing septicemia in children early after HSCT for major β-thalassemia, and the bacteria show a high level of drug resistance. Adequate preventive use of antibiotics and care of the oral cavity, the respiratory tract, and the perianal region following the transplantation are important measures to control nosoconial infection in these children.
authors.affiliation: Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. E-mail: 453351315@qq.com.
authors.forename: Yan-Jun
authors.initials: YJ
authors.lastname: Xu
authors.forename: Chun-Fu
authors.initials: CF
authors.lastname: Li
authors.forename: Yue-Lin
authors.initials: YL
authors.lastname: He
authors.forename: Xiao-Qin
authors.initials: XQ
authors.lastname: Feng
authors.forename: Fu-Yu
authors.initials: FY
authors.lastname: Pei
authors.forename: Xue-Dong
authors.initials: XD
authors.lastname: Wu
mesh_terms: D000900:Anti-Bacterial Agents; D001419:Bacteria; D002648:Child; D003428:Cross Infection; D006090:Gram-Negative Bacteria; D006801:Humans; D015994:Incidence; D055624:Methicillin-Resistant Staphylococcus aureus; D012189:Retrospective Studies; D018805:Sepsis; D033581:Stem Cell Transplantation; D001618:beta-Lactamases; D017086:beta-Thalassemia / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases