Pseudomonas putida bacteremia in pediatric patients: A case series study

Abstract

Introduction: Bacteria of the genus Pseudomonas act as opportunistic pathogens. Pseudomonas putida has been considered a pathogen of low virulence and susceptible to multiple antibiotics, but in recent years resistant strains have emerged. The objective of this study is to describe the clinical characteristics, evolution and antibiotic resistance of P. putida bacteremia documented in pediatric hospitalized patients.

Methods: Retrospective cases series. Pediatric patients admitted to the Prof. Dr. Juan P. Garrahan Hospital of Buenos Aires City, Argentina, with isolation in blood cultures of P. putida were included, between August 2015 and August 2020.

Results: Sample consisting of 13 patients. Median age: 81 months (IQR 15-163). Ten of the patients were immunocompromised (77%), 11 (85%) had a central venous catheter, 2 (15%) received transfusions prior to the episode of bacteremia, and 6 (46%) had had an invasive procedure within the previous 30 days. Three patients (23%) presented bacteremia secondary to clinical focus and 10 (77%) had central venous catheter-associated bacteremia. All presented fever, 62% (8) evolved with sepsis and 15% (2) with septic shock. Two patients required admission to the intensive care unit (15%), and in 7 (54%) the central venous catheter was removed. None died. The median days of treatment was 14 (IQR 10-14). Resistance to carbapenems was 30%.

Conclusion: All children had underlying comorbidities, most of them immunocompromised. Catheter-associated infection predominated. The sensitivity to antibiotics was variable. Given the emergence of multi-resistant strains, it is essential to know the local epidemiology.

Keywords: Bacteremia; Bacteriemia; Catéter venoso central; Central venous catheter; Infección nosocomial; Nosocomial infection; Pseudomonas putida.