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Published on: February 10, 2011
Bloodstream infections in pediatric patients at Cancer Institute, Chennai
V Radhakrishnan1, V Vijaykumar, P Ganesan
1Department of Medical Oncology, Cancer Institute, Adyar, Chennai, Tamil Nadu, India.
Insights
Bloodstream infections in Indian pediatric cancer patients are mainly caused by Gram-negative bacteria. High resistance to common antibiotics necessitates revised empiric therapy for febrile neutropenia.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Microbiology
Background:
- Limited data exists on bloodstream infections (BSIs) in pediatric cancer patients in India.
- Appropriate antibiotic use in febrile neutropenia is crucial for reducing morbidity and preventing antimicrobial resistance.
Purpose of the Study:
- To determine the prevalence of bloodstream bacterial infections.
- To analyze the antibiotic resistance patterns in pediatric cancer patients at Cancer Institute, Chennai.
Main Methods:
- Retrospective analysis of blood cultures from pediatric cancer patients treated in 2013.
- Evaluation of microbiological profiles and antimicrobial sensitivity patterns.
Main Results:
- Out of 1045 blood cultures, 82 (7.5%) were positive for bacterial growth.
- Gram-negative organisms (61%) predominated, with Klebsiella pneumoniae being the most common.
- Staphylococcus aureus was the most frequent Gram-positive isolate (93.5%).
- High resistance rates were observed against aminoglycosides and beta-lactam/beta-lactamase inhibitors.
Conclusions:
- Gram-negative bacteria are the primary cause of BSIs in this pediatric cancer cohort.
- Significant resistance to first-line empiric antibiotics for febrile neutropenia was identified.
Background:
There is paucity of data on the epidemiology of bloodstream infections in pediatric cancer patients from India. Rationale use of antibiotics in febrile neutropenia is important for reducing morbidity and preventing the emergence of drug resistant bacteria.
Aims:
The study was conducted to look at the prevalence of bloodstream bacterial infection and the antibiotic resistance profile at Cancer Institute, Chennai.
Settings And Design:
This was a retrospective study.
Materials And Methods:
Data on all blood cultures taken from pediatric cancer patients treated at Cancer Institute, Chennai, during the year 2013 were analyzed. The microbiological profile and sensitivity pattern were analyzed.
Results:
A total of 1045 blood culture samples were taken, and there were 82/1045 (7.5%) positive blood cultures. Gram-negative organisms accounted for 50/82 (61%) of all positive cultures. Klebsiella pneumoniae (32%) was the most common Gram-negative isolate, and Staphylococcus aureus (93.5%) was the most common Gram-positive. There was high resistance to aminoglycosides and beta-lactam/beta-lactamase inhibitor antibodies.
Conclusion:
Gram-negative organisms are the predominant bacteria isolated. There is high resistance to first-line combination antibiotics used as empiric therapy for treatment of febrile neutropenia.
