Frequency and Antimicrobial Resistance Patterns of Bloodstream Infections in Pediatric Cancer Patients
N Mehdi, N Majeed, H Javaid, A AmjadAbstract
Aim/Background
Prevalence of multidrug resistant bacterial bloodstream infections have emerged as a leading cause of morbidity and mortality in paediatric cancer patients. The objective of study is to determine bacterial spectrum and antimicrobial susceptibility patterns of blood stream infections in paediatric oncology pediatric patients, under 15 years of age.
Methods
This cross-sectional study was conducted during a period of 4 months at Department of Microbiology, University of Child health sciences, Children’s hospital Lahore. A total of 174 specimens of blood cultures were collected from pediatric cancer patients to assess the distribution of bacterial pathogens and incubated at 370 C for 7 days. After observing the signs of growth, samples were subcultured on blood and MacConkey agar and were then aerobically incubated at 37° C for 18-24 hours. Standard microbiological methods including Gram staining, biochemical tests, analytical profile index and Kirby-Bauer disk diffusion methods were used for the identification and antimicrobial sensitivity testing of the isolated organisms.
Results
In this study males constituted 58% of the cases. Thirty-nine (22.4%) were culture positive. Among the isolates, Gram-negative organisms were predominant, accounting for 84.6% of the infections, while Gram-positive organisms represented 15.4%. All Gram-positive organisms were identified as Methicillin resistant Staph aureus. Gram negative organism comprised of 39.9% Klebsiella pneumoniae followed by 18.1% E. coli, 09% Pseudomonas aeruginosa, 09% Acinetobacter baumanii, 09% Serratia marcescens, 6% Salmonella spp., 3% Citrobacter spp., 3% Burkholderia cepacia and Stenotrophomonas maltophilia each. High resistance to multiple groups of antibiotics including β-lactams, β-lactam combinations, cephalosporins, quinolones, aminoglycosides and carbapenems was observed in most of the isolates. 62.5% isolates were carbapenem resistant.
Conclusion
Multi drug resistant Gram Negative bacteria are common etiologic isolate of bloodstream infections (BSIs) in cancer patients, which continues to be a significant health concern. The most common isolate is K. pneumoniae which is resistant to almost all of the available antibiotics. The findings highlight a significant predominance of Gram-negative bacterial infections in this population, underscoring the need for tailored empirical therapy and robust infection control measures.