title: [Causative agents of bloodstream infections in children with neoplasm, in 5 hospitals of Santiago (1994-1998)].
abstract: BACKGROUND
  Pediatric patients in treatment for cancer can have fatal bacterial infections. Thus, in the presence of fever or other signs infection, antimicrobials have to be prescribed empirically.
  
  
  OBJECTIVE
  To know the causative agents of bacteremia in children with cancer, their changes with time and between different hospitals and their patterns of susceptibility.
  
  
  METHODS
  We reviewed the blood cultores of children with cancer in five hospitals of Santiago, from 1994 at 1998.
  
  
  RESULTS
  During the study period, 707 agents were isolated. The most frequently isolated species or genus were coagulase negative Staphylococcus (43%), Staphylococcus aureus (16%), Escherichia coli (9%), Klebsiella spp. (8%), Pseudomonas spp. (5%) and Candida spp. (4%). Coagulase negative Staphylococcus was 55% resistant to meticilin and S. aureus was 44% resistant. Enterobacteriaceae had 15% resistance to gentamicin and amikacin, 2% to imipenem, 26% to ceftriaxone, 21% to cefotaxime and 20% to ceftazidime. Among non fermenting agents resistance was 6% for imipenem, 9% for amikacin 10% for ciprofloxacin, 19% for ceftazidime and 22% for cefoperazone. The resistance of Streptococcus spp. (non pneumoniae) to penicillin reached 50% and that of Enterococcus spp. was of 33%.
  
  
  CONCLUSIONS
  Treatment for pediatric patients with cancer must be modified and new guidelines including more active medications for patients at risk for bacteremia, should be devised.
authors.affiliation: Hospitale Dr. Exequiel González Cortés, Santiago de Chile. epaya@entelchile.net
authors.forename: E
authors.initials: E
authors.lastname: Payá
authors.forename: A M
authors.initials: AM
authors.lastname: Alvarez
authors.forename: C
authors.initials: C
authors.lastname: Avilés
authors.forename: J
authors.initials: J
authors.lastname: Cofré
authors.forename: N
authors.initials: N
authors.lastname: Enríquez
authors.forename: C
authors.initials: C
authors.lastname: Salgado
authors.forename: M E
authors.initials: ME
authors.lastname: Santolaya
authors.forename: P
authors.initials: P
authors.lastname: Silva
authors.forename: J
authors.initials: J
authors.lastname: Tordecilla
authors.forename: M
authors.initials: M
authors.lastname: Varas
authors.forename: M
authors.initials: M
authors.lastname: Villarroel
authors.forename: M
authors.initials: M
authors.lastname: Zubieta
mesh_terms: D000293:Adolescent; D016470:Bacteremia / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D002677:Chile; D003428:Cross Infection / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008826:Microbial Sensitivity Tests; D009369:Neoplasms / Q000150:complications*