title: Spectrum of systemic bacterial infections during febrile neutropenia in pediatric oncology patients in tertiary care pediatric center.
abstract: BACKGROUND
  Outcome of pediatric cancers has significantly improved with modern chemotherapy and good supportive care. However, febrile neutropenia remains one of the important limiting factors in these patients especially with the emergence of resistant organisms. Choosing appropriate antimicrobials is possible only if we understand the local microbial spectrum and their sensitivity pattern.
  
  
  OBJECTIVE
  To study the likely etiologic agents and their antibiotic sensitivity pattern among systemic infections in children with cancer.
  
  
  METHODS
  This is a prospective study.
  
  
  METHODS
  The study was conducted at a tertiary care center for pediatrics, in which culture samples representing blood stream infections and others like urinary tract infections sent from the Oncology services of the Hospital during the year of 2013 were analyzed. The microbiological profile and antibiotic sensitivity pattern of these isolates were studied.
  
  
  RESULTS
  There were 89 isolates that represented blood and urinary tract infections in neutropenic patients with cancer.Out of 89 positive cultures 76 were gram negative isolates. The most common gram negative bacterial isolates were Escherichia coli 33 (37%), followed by Pseudomonas 21 (23.5%). Acinetobacter grew in 2 patients (2.2%). Extended spectrum beta-lactamases (ESBL's), carbepenem resistant and pan-resistant organisms seen in 28 (31.4%), 5 (5.6%) and 2 cases (2.3%) respectively. Over all Gram-positive organisms were 13/89 (12.3%). Staphylococcus was the most common Gram-positive organism and methicillin resistant Staphylococcus aureus seen in 5 each.
  
  
  CONCLUSIONS
  Gram-negative organism is a common isolate in cancer children with febrile neutropenia, which is resistant to first-line antibiotic cefepime. Meropenem is most sensitive antibiotic and ESBL's are sensitive to piperacillin-tazobactam.
authors: Department of Pediatric Hematology Oncology, Rainbow Childrens Hospital, Banjara Hills, Hyderabad, Telangana, India.
authors: Sirisharani
authors: S
authors: Siddaiahgari
authors: A
authors: A
authors: Manikyam
authors: K Anand
authors: KA
authors: Kumar
authors: A
authors: A
authors: Rauthan
authors: R
authors: R
authors: Ayyar
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology*; D052978:Disk Diffusion Antimicrobial Tests; D024881:Drug Resistance, Bacterial; D064147:Febrile Neutropenia / Q000150:complications*; D006776:Hospitals, Pediatric; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D011446:Prospective Studies; D062606:Tertiary Care Centers; D014552:Urinary Tract Infections / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents