Bloodstream Infections Caused by Serratia marcescens: Have a High Prevalence of ESBL and Carbapenemase Production in Pediatric Patients

et al. Bloodstream infections caused by Serratia marcescens : Have a high prevalence of esbl and carbapenemase production in pediatric patients. J Pediatr Inf 2022;16(3):e173-e178. mevcut-Abstract Objective: In this study, it was aimed to present a cohort study conduct-ed retrospectively in order to examine the unexpected Serratia marcescens bacteremia prevalence in a children’s hospital in Türkiye. Material and Methods: S. marcescens was isolated in the blood cultures of 45 patients at a 20-month period. Demographic features and clinical findings of the 45 patients including age, sex, underlying diseases, white blood cell (WBC), C-reactive protein (CRP), serum albumin level, length of hospital stay and length of pediatric intensive care unit stay, portal of entry, duration of central venous catheter, results of antimicrobial susceptibility testing and 28-day all-cause mortality were examined. BSI. Definitions used to characterize antimicrobial resistant bacteria were classified as multidrug-resistant (MDR), extensively drug-resistant (XDR) and pandrug-resistant (PDR). Results: Twelve patients (26.9%) had a malignancy. Mean hospitalization duration was 42.7 ± 41.4 (3-171) days. Central venous catheters (CVCs), including chemo-ports and Hickman catheters, were present in 43 patients during episodes of BSI. Twenty-four patients had primary BSI while 21 patients had catheter-related BSI. Mean length of CVC presence be-Available direnç fore catheter-related BSI was 46.02 ± 50.96 (1-200) days. During bacteremia episodes, 24 catheters (55.8%) were removed. Four patients (8.9%) died during the bacteremia episode. Laboratory findings of the deceased patients were as follows: mean WBC was 17.200/mm³; mean serum CRP level was 147.2 mg/L; and mean serum albumin level was 2.43 g/dL. Among all cases, 57.8% of the S. marcescens isolates produced ESBL and 40% produced carbapenemase. We classified these isolates as non-MDR (42.2%), MDR (31.1%), XDR (24.4%) and PDR (2.2%). The most common regimes received for XDR isolates were high-dose prolonged meropenem, amikacin, levofloxacin, and tigecycline. Conclusion: It is a great concern that S. marcescens isolates are intrinsi-cally resistant to polymyxins and produce ESBL and carbapenemase. Our mortality rate was reduced by high-dose prolonged-infusion of meropenem and early catheter removal.