Backgrounds:

Multidrug resistant bacteria (MDRB) infections are a rising concern, especially those associated with healthcare environments. The aims of this study were to describe the characteristics of MDRB colonizations in paediatric patients admitted to a Haemato-Oncology ward and to establish the risk of having a MDRB infection in a patient previously colonised.

Methods

Multicentre prospective observational study from May 2021-March 2022 in Spain. Patients < 18 years with diagnosis of cancer or hematopoietic stem cell transplantation (HSCT) admitted to Hemato-Oncology wards, were included. Rectal and nasal swabs for MDRB detection were performed at inclusion and periodically during a 90-day follow-up period. Active infection surveillance was performed during follow-up.

Data of colonization at baseline is presented.

Results:

111 patients were included: Median age was 8 (±5,5) years and 60 (54,1%) were women. Most common diagnosis were leukemia (52;46.8%), solid tumour (43;38.7%), sickle cell disease (SCD) (6;5.4%) and lymphoma (4;3.6%). 20 (18%) had undergone a HSCT.

14 (12.6%) had a MDRB colonization at baseline and 3 (2.7%) a double colonization. MDRB detected were ESBL-producing enterobacteria (7;50%), carbapenemase-producing enterobacteria (6;42.9%), MDR-Pseudomonas (2;14.3%) and MRSA (1;7.1%). No MDR-Acinetobacter or vancomycin-resistant Enterococcus were detected. The main ESBL-producing enterobacteria was E. coli (75%) and the main carbapenemase detected, VIM (66.7%). Risk factors for MDRB colonization were SCD diagnosis (p=0.03) and a previous colonization (p<0.01). Children with colonizations were more likely to have a HSCT and their father’s were more likely to have been born abroad, with no statistical significance.

Conclusions/Learning Points:

Rates of ESBL and carbapenemase-producing enterobacteria colonization in a cohort of paediatric patients with cancer or SCT in Spain was high.

Children with SCD and a previous colonization have a higher risk