Polymyxin B sulfate for carbapenem-resistant Gram-negative bacilli infections in pediatric liver transplant recipients: a retrospective study
10.3760/cma.j.cn421203-20241024-00214
- VernacularTitle:硫酸多黏菌素B治疗婴幼儿肝移植术后碳青霉烯耐药革兰阴性菌感染
- Author:
Sinan GAO
1
;
Yan SUN
;
Wenjie YANG
;
Bing WANG
Author Information
1. 天津市第一中心医院外科ICU，天津 300380
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
Pediatric;
Polymyxin;
Carbapenem antibiotic;
Gram-negative bacteria
- From:
Chinese Journal of Organ Transplantation
2025;46(11):772-778
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical efficacy and safety of polymyxin B sulfate in the treatment of carbapenem-resistant Gram-negative bacilli (CR-GNB) infections in pediatric liver transplant recipients.Method:This retrospective study included 13 children under 3 years of age who developed CR-GNB infections after liver transplantation and received polymyxin B sulfate-based combination therapy in the Surgical Intensive Care Unit (ICU) of Tianjin First Central Hospital between June 2020 and June 2023. Clinical data-including recipient characteristics, microbiological culture and susceptibility results, antibiotic regimens and duration, and laboratory parameters before and after polymyxin B sulfate treatment-were collected to assess bacterial clearance, clinical efficacy, and drug-related adverse events.Result:The median age was 7.5 months. Infection sites included intra-abdominal, bloodstream, and combined intra-abdominal plus bloodstream infections. A total of 13 CR-GNB strains were isolated: Klebsiella pneumoniae (6 cases), Escherichia coli (3 cases), Acinetobacter baumannii (3 cases), and Enterobacter cloacae (1 case). The median duration of polymyxin B sulfate therapy was 14 days. Clinical improvement was achieved in 11 recipients, bacterial eradication in 10 recipients, while 2 recipients died due to clinical failure. The incidence of adverse reactions was low.Conclusion:Polymyxin B sulfate appears to be a feasible and relatively safe therapeutic option for CR-GNB infections in pediatric liver transplant recipients.
