Related Experiment Video
Updated: Aug 19, 2026
A Controlled Mouse Model for Neonatal Polymicrobial Sepsis
Published on: January 27, 2019
Sepsis in febrile neutropenic children with cancer
1Department of Pediatrics, Faculty of Medicine, University of Toronto, Ontario, Canada.
Insights
Infections are a major threat to children with cancer. This study found Gram-positive bacteria, particularly coagulase-negative staphylococci, are common causes of sepsis, often resistant to initial antibiotics.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Microbiology
Background:
- Infection remains the primary cause of mortality in pediatric cancer patients.
- Sepsis poses a significant threat, necessitating effective antimicrobial strategies.
Purpose of the Study:
- To analyze the causative pathogens of sepsis in children with cancer.
- To evaluate the susceptibility of these pathogens to common empiric antibiotic regimens.
- To inform optimal antibiotic choices for managing sepsis in this vulnerable population.
Main Methods:
- Retrospective review of 100 sepsis episodes in 80 pediatric cancer patients over 21 months.
- Identification and antimicrobial susceptibility testing of bacterial isolates.
- Analysis of resistance patterns, particularly for Gram-positive pathogens.
Main Results:
- Gram-positive bacteria constituted 74% of isolates, with coagulase-negative staphylococci being the most frequent (35%).
- Significant resistance (31%) of Gram-positive isolates to piperacillin and tobramycin was observed.
- Methicillin resistance was noted in 38% of coagulase-negative staphylococci, though vancomycin showed universal susceptibility.
Conclusions:
- The rising incidence of coagulase-negative staphylococci in pediatric cancer sepsis warrants reconsideration of empiric antibiotic therapy.
- Inclusion of vancomycin or an antistaphylococcal penicillin in initial regimens may be necessary, guided by local methicillin resistance rates.
Abstract:
Infection is the leading cause of death in children with cancer. A retrospective review of 100 episodes of sepsis in 80 children with cancer for a 21-month period showed that 74% of isolates were Gram-positive bacteria. Coagulase-negative staphylococci were the most common pathogens, accounting for 35% of all isolates. Initial empiric antibiotic therapy of fever in neutrogenic cancer patients was piperacillin and tobramycin. All but 12% of the Gram-negative isolates were susceptible to one or both of the antibiotics. However, 31% of the Gram-positive isolates were resistant to both antibiotics and 38% of the coagulase-negative staphylococci were methicillin-resistant. All of the latter were susceptible to vancomycin. The increasing incidence of coagulase-negative staphylococci as causes of sepsis in cancer patients suggests that the choice of antibiotics for initial empiric therapy may need to include vancomycin or an antistaphylococcal penicillin depending on the local incidence of methicillin resistance.
