Clin Pediatr Hematol Oncol.  2008 Oct;15(2):65-74.

A Survey for Causative Organisms and Antimicrobial Susceptabilities of Bacteremia in a Single Center Children with Hemato-Oncologic Diseases (2004~2006)

• Lee HJ
• Lee JW
• Kim JH
• Lee KH
• Chung NG
• Lee DG
• Lee MJ
• Choi SH
• Kang JH
• Lee SJ
• Jeong DC
• Cho B
• Kim HK

Abstract

PURPOSE: We elucidated the causative organisms and antimicrobial susceptibility patterns in pediatric hemato-oncological patients with bacteremia to make a guideline for the empiric antimicrobial therapy.
METHODS
A retrospective survey of the pediatric hemato-oncological patients with bacteremia in Saint Mary's Hospital, the Catholic University of Korea, from January 2004 to December 2006 was performed with medical records.
RESULTS
There were 138 episodes of culture proven bloodstream infections in 104 patients. Among the isolated 138 pathogens, 63 (45.6%) were gram-negative and 65 (47.1%) were gram-positive bacteria. Coagulase-negative staphylococci (n=26, 19.6%), Pseudomonas species (n=24, 17.4%), Klebsiella species (n=13, 9.4%) were the most common pathogens. Antimicrobial resistance rates in gram-positive bacteria to penicillin, oxacillin and vancomycin were 67.7%, 43.1%, and 13.8%, respectively, and those of gram-negative bacteria to ceftriaxone, piperacillin/tazobactam and imipenem were 28.6%, 9.5%, and 15.9%, respectively. Gram-negative organisms were more often associated with bacteremia in intensive care than gram-positive organisms (11.1% vs 5.1%, P<0.001). And gram-negative bacteremic patients had a more fatal course during neutropenic periods (24.3% vs 14.8%, P= 0.007).
CONCLUSION
A shift from gram-negative to gram-positive bacteremia in the causative organisms of bloodstream infections has been occurring in hemato-oncologcal patients, recently. However, patients with gram-negative bacteremia had a more fatal course than those with gram-positive one in neutropenic period. These facts should be taken into consideration during management of pediatric hemato-oncological patients with infectious complications. Gram-negative, Hemato-oncological patients, Children.

Keyword

Bacteremia; Antimicrobial susceptibility; Causative organism; Gram-positive; Gram-negative; Hemato-oncological patients; Children

MeSH Terms

Bacteremia
Ceftriaxone
Child
Gram-Negative Bacteria
Gram-Positive Bacteria
Humans
Imipenem
Critical Care
Klebsiella
Korea
Oxacillin
Penicillins
Pseudomonas
Retrospective Studies
Saints
Vancomycin
Ceftriaxone
Imipenem
Oxacillin
Penicillins
Vancomycin