title: Comparison of Antimicrobial Sensitivity to Older and Newer Quinolones versus Piperacillin-Tazobactam, Cefepime and Meropenem in Febrile Patients with Cancer in two Referral Pediatric Centers in Tehran, Iran.
abstract: BACKGROUND
  Infection in pediatric cancer patients has become a concerning problem due to increasing antimicrobial resistance. The goal of this study was to determine the antimicrobial resistance patterns of blood isolates from pediatric oncology patients in Iran to determine if there was significant resistance to quinolones.
  
  
  METHODS
  Children with cancer who were admitted with or developed fever during admission to Aliasghar Children's Hospital or Mahak Hospitals July 2009 through June 2011 were eligible for enrollment. Two blood cultures were obtained. Antimicrobial sensitivity test was performed for ciprofloxacin, moxifloxacin, gatifloxacin, meropenem, cefepime, and piperacillin-tazobactam on isolates from children who were bacteremic.
  
  
  RESULTS
  Blood cultures were positive for 38 episodes in 169 enrolled children but 9 episodes were excluded as blood cultures were thought to be contaminated, yielding a bacteremia rate of 29/160 (18%). The mean age of children and the stage of malignancy did not differ between those with and without bacteremia. Meropenem was the most likely antibiotic to cover isolates (97%) with cefepime having the lowest coverage rate (21%). Quinolone coverage ranged from 63% to 76%.
  
  
  CONCLUSIONS
  Quinolones may not be suitable for use as empiric therapy in febrile pediatric oncology patients in Iran.
authors.affiliation: Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Ar
authors.initials: A
authors.lastname: Nateghian
authors.affiliation: Department of Pediatrics, University of Alberta and Stollery Children's Hospital. Edmonton, Canada.
authors.forename: Jl
authors.initials: J
authors.lastname: Robinson
authors.affiliation: Mahak Hospital and Rehabilitation Complex, Tehran, Iran.
authors.forename: P
authors.initials: P
authors.lastname: Vosough
authors.affiliation: Pediatric Infections Research Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Navidinia
authors.affiliation: Pediatric Infections Research Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Malekan
authors.affiliation: Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: A
authors.initials: A
authors.lastname: Mehrvar
authors.affiliation: Mahak Hospital and Rehabilitation Complex, Tehran, Iran.
authors.forename: B
authors.initials: B
authors.lastname: Sobouti
authors.affiliation: Aliasghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: P
authors.initials: P
authors.lastname: Bahadoran
authors.affiliation: Pediatric Infections Research Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Z
authors.initials: Z
authors.lastname: Gholinejad