title: Increasing Antimicrobial Resistance Monitored in Surveillance Analysis of Blood Stream Infections in Febrile Neutropenic Pediatric Oncology Patients.
abstract: BACKGROUND
  Continuous surveillance of pattern of blood stream infection is necessary in febrile neutropenia (FN)especially with the recent escalating trend in the management of pediatric cancer patients towards intensified regimens and with the increase in infections caused by resistant organisms limiting the choice of antibiotics.
  
  
  OBJECTIVE
  To monitor change in pattern of blood stream infections (BSI) in FN pediatric cancer patients.
  
  
  METHODS
  Surveillance of FN episodes with positive BSI was prospectively monitored and compared to a previous surveillance in the same pediatric oncology unit.
  
  
  RESULTS
  A total of 232 BSI positive episodes were documented in 192 patients during a 6 months period. The results of recent surveillance analysis showed an increase in intensified regimens of chemotherapy, antimicrobial resistance, fungal infections, and prolonged duration of episodes when compared to previous surveillance, with p value sof <0.001, 0.005, 0.021, and <0.001, respectively. There was an apparent decrease in the crude mortality but this was not statistically significant, to 6% in 2011 from 10 % in 2006.
  
  
  CONCLUSIONS
  The pattern of BSI at our institution is still inclining towards gram positive organisms but is showing a shift towards more antibiotic resistance and fungal infections.
authors: Clinical Pathology Department, National Cancer Institute, Cairo University Cairo, Egypt E-mail : wakilmohamed171@gmail.com.
authors: Hadir A
authors: HA
authors: El-Mahallawy
authors: Safaa Shawky
authors: SS
authors: Hassan
authors: Mohamed
authors: M
authors: El-Wakil
authors: Manar M
authors: MM
authors: Moneer
authors: Lobna
authors: L
authors: Shalaby
mesh_terms: D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D018432:Drug Resistance, Multiple; D005260:Female; D005334:Fever / Q000150:complications / Q000188:drug therapy*; D016469:Fungemia / Q000097:blood*; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000097:blood* / Q000188:drug therapy*; D009503:Neutropenia / Q000097:blood*; D011159:Population Surveillance; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000890:Anti-Infective Agents