title: Comparison of isolates and antibiotic sensitivity pattern in pediatric and adult cancer patients; is it different?
abstract: BACKGROUND
  Infection is a common cause of mortality and morbidity in cancer patients. Organisms are becoming resistant to antibiotics; age appears to be one of the factors responsible. We analyzed common organisms and their antibiotic sensitivity pattern in the correlation with age.
  
  
  METHODS
  This is a single institutional, retrospective analysis of all culture positive adult and pediatric cancer patients from January 2007 to December 2007. For statistical analysis, Chi-square test for trend was used and P values were obtained. Of 1251 isolates, 262 were from children <12 years of age and 989 were from adolescents and adults (>12 years of age). Gram-negative organisms were predominant (64.95) while Gram-positive constituted 35.09% of isolates.
  
  
  RESULTS
  The most common source in all age groups was peripheral-blood, accounting to 47.8% of all samples. The most common organisms in adults were Pseudomonas aeruginosa (15.3%) while in children it was coagulase negative Staphylococcus aureus (19.8%). Antibiotic sensitivity was different in both groups. In pediatric group higher sensitivity was seen for Cefoparazone-sulbactum, Cefipime, Amikacin, and Tobramycin. No resistance was found for Linezolid.
  
  
  CONCLUSIONS
  The isolates in both children and adults were predominantly Gram-negative though children had proportionately higher Gram-positive organisms. High-dose cytarabine use, cotrimoxazole prophylaxis, and frequent use of central lines in children especially in hematological malignancies could explain this observation. Children harbor less antibiotic resistance than adults; Uncontrolled, cumulative exposure to antibiotics in our community with increasing age, age-related immune factors and variable bacterial flora in different wards might explain the higher antibiotic resistance in adults. Thus age is an important factor to be considered while deciding empirical antibiotic therapy.
authors: K
authors: K
authors: Prabhash
authors: Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors: J
authors: J
authors: Bajpai
authors: A
authors: A
authors: Gokarn
authors: B
authors: B
authors: Arora
authors: P A
authors: PA
authors: Kurkure
authors: A
authors: A
authors: Medhekar
authors: R
authors: R
authors: Kelkar
authors: S
authors: S
authors: Biswas
authors: S
authors: S
authors: Gupta
authors: V
authors: V
authors: Naronha
authors: N
authors: N
authors: Shetty
authors: G
authors: G
authors: Goyel
authors: S D
authors: SD
authors: Banavali
mesh_terms: D000150:Acinetobacter / Q000187:drug effects / Q000302:isolation & purification; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D002648:Child; D052978:Disk Diffusion Antimicrobial Tests; D024881:Drug Resistance, Bacterial; D016983:Enterococcus / Q000187:drug effects / Q000302:isolation & purification; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D007709:Klebsiella / Q000187:drug effects / Q000302:isolation & purification; D009369:Neoplasms / Q000150:complications*; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification; D012189:Retrospective Studies; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013291:Streptococcus / Q000187:drug effects / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents