Korean J Pediatr Infect Dis.  2012 Dec;19(3):131-140.

Etiological Agents in Bacteremia of Children with Hemato-oncologic Diseases (2006-2010): A Single Center Study

• Kang JE
• Seok JY
• Yun KW
• Kang HJ
• Choi EH
• Park KD
• Shin HY
• Lee HJ
• Ahn HS

Abstract

PURPOSE
This study was performed to identify the etiologic agents and antimicrobial susceptibility patterns of organisms responsible for bloodstream infections in pediatric cancer patients for guidance in empiric antimicrobial therapy.
METHODS
A 5-year retrospective study of pediatric hemato-oncologic patients with bacteremia in Seoul National University Children's Hospital, from 2006 to 2010 was conducted.
RESULTS
A total of 246 pathogens were isolated, of which 63.4% (n=156) were gram-negative, bacteria 34.6% (n=85) were gram-positive bacteria, and 2.0% (n=5) were fungi. The most common pathogens were Klebsiella spp. (n=61, 24.8%) followed by Escherichia coli (n=31, 12.6%), coagulase-negative staphylococci (n=23, 9.3%), and Staphylococcus aureus (n=22, 8.9%). Resistance rates of gram-positive bacteria to penicillin, oxacillin, and vancomycin were 85.7%, 65.9%, and 9.5%, respectively. Resistance rates of gram-negative bacteria to cefotaxime, piperacillin/tazobactam, imipenem, gentamicin, and amikacin were 37.2%, 17.1%, 6.2%, 32.2%, and 13.7%, respectively. Overall fatality rate was 12.7%. Gram-negative bacteremia was more often associated with shock (48.4% vs. 11.9%, P<0.01) and had higher fatality rate than gram-positive bacteremia (12.1% vs. 3.0%, P=0.03). Neutropenic patients were more often associated with shock than non-neutropenic patients (39.6% vs. 22.0%, P=0.04).
CONCLUSION
This study revealed that gram-negative bacteria were still dominant organisms of bloodstream infections in children with hemato-oncologic diseases, and patients with gram-negative bacteremia showed fatal course more frequently than those with gram-positive bacteremia.

Keyword

Bacteremia; Pediatric cancer; Neutropenia; Fever

MeSH Terms

Amikacin
Bacteremia
Bacteria
Cefotaxime
Child
Escherichia coli
Fever
Fungi
Gentamicins
Gram-Negative Bacteria
Gram-Positive Bacteria
Humans
Imipenem
Klebsiella
Neutropenia
Oxacillin
Penicillins
Retrospective Studies
Shock
Staphylococcus aureus
Vancomycin
Amikacin
Cefotaxime
Gentamicins
Imipenem
Oxacillin
Penicillins
Vancomycin

Figure

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  Fig. 1 Percentage of each pathogens during years of 2002-2005 versus years of 2006-2010.

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  Fig. 2 Proportion of gram-positive, gram-negative bacteria and fungus isolated from bloodstream infections during years of 2002-2005 versus years of 2006-2010.

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