title: [Pathogens of infections in the induction period of childhood acute lymphoblastic leukemia and drug resistance of isolated strains].
abstract: OBJECTIVE
  To investigate the infections occurring in the induction period of childhood acute lymphoblastic leukemia (ALL), the pathogens of the infections, and drug resistance of isolated strains.
  
  
  METHODS
  A retrospective analysis was performed for the clinical data of 130 children with newly-diagnosed childhood ALL. Infections occurring during the induction chemotherapy, pathogenic strains, and drug-resistance spectrum were analyzed.
  
  
  RESULTS
  The incidence rate of clinical infection and/or microbial infection reached 76.2%. The lungs were the most common infection site (46.2%). The children with severe infection accounted for 52.3%, among whom 60 had pulmonary infection and/or 21 had sepsis. A total of 50 pathogenic strains were detected, which consisted of 29 bacterial strains and 21 fungal strains. Of all the children, 28.5% experienced infections caused by at least one microbe. Among the 29 bacterial strains, there were 19 (65.5%) Gram-negative bacteria and 10 (34.5%) Gram-positive bacteria. The most common Gram-negative bacteria were Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa, which were 100% sensitive to imipenem. The most common Gram-positive bacterium was Streptococcus viridans, which was 100% sensitive to vancomycin. The infections caused by fungi accounted for 16.2%, with Candida albicans as the most common fungus. Compared with those with non-severe infections, the children with severe infections had a significantly shorter time to the occurrence of agranulocytosis, a significantly longer duration of agranulocytosis, significantly higher incidence of fever and C-reactive protein (CRP) level, and a significantly longer length of hospital stay (P<0.05).
  
  
  CONCLUSIONS
  Pulmonary infections are common in the induction period of childhood ALL. Gram-negative bacteria are the most common pathogenic bacteria. Severe infections can be controlled by carbapenems combined with vancomycin and antifungal agents.
authors.affiliation: Fujian Institute of Hematology/Fujian Key Laboratory on Hematology/Fujian Medical University Union Hospital, Fuzhou 350001, China. chenzs_xh@163.com.
authors.forename: Zai-Sheng
authors.initials: ZS
authors.lastname: Chen
authors.forename: Ling
authors.initials: L
authors.lastname: Zheng
authors.forename: Yi-Qiao
authors.initials: YQ
authors.lastname: Chen
authors.forename: Jing-Hui
authors.initials: JH
authors.lastname: Yang
authors.forename: Jian
authors.initials: J
authors.lastname: Li
mesh_terms: D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology; D001419:Bacteria / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D012189:Retrospective Studies