Browse > Article

Bacteremia in pediatric cancer patients : A single center study  

Park, Sun Mi (Department of Pediatrics, Keimyung University School of Medicine)
Choe, Byung Kyu (Department of Pediatrics, Keimyung University School of Medicine)
Kim, Chun Soo (Department of Pediatrics, Keimyung University School of Medicine)
Kim, Joon Sik (Department of Pediatrics, Keimyung University School of Medicine)
Kim, Heung Sik (Department of Pediatrics, Keimyung University School of Medicine)
Ryoo, Nam-Hee (Department of Laboratory Medicine, Keimyung University School of Medicine)
Publication Information
Clinical and Experimental Pediatrics / v.49, no.8, 2006 , pp. 882-888 More about this Journal
Abstract
Purpose : Bacteremia is one of the major concerns in the treatment of pediatric cancer patients. This study was to determine the etiologic agents and the pattern of antibiotic susceptibilities in a single tertiary medical center. Methods : We retrospectively reviewed the medical records of the cases of bacteremia in pediatric cancer patients from 1998 to 2005 in Keimyung University Dongsan Medical Center. Results : There were 62 cases of bacteremia from 44 patients. Gram-positive organisms(48.3%) were more common than gram-negative organisms(38.7%) or fungi(13%). Among gram-positive organisms, Staphylococcus epidermidis was the most common etiologic agent(63.3%), followed by Staphylococcus aureus(16.7%), ${\alpha}$-hemolytic Streptococcus(16.7%), and Streptococcus mitis(3.3%). Among gram-negative organisms, Alcaligenes xylosoxidans was the most common agent(41.7%) and the other organisms were Klebsiella pneumoniae(20.8%), Stenotrophomonas maltophilia(12.5%), Acinetobacter baumanii(8.2%), etc. In febrile neutropenic patients, however, K. pneumoniae was the most common cause of gram-negative bacteremia. All of the isolated K. pneumoniae in our center produced extended-spectrum beta-lactamase and were related with high mortality. S. aureus, S. epidermidis, and Streptococcus species were all susceptible to vancomycin and teicoplanin. Most staphylococci were resistant to penicillin and oxacillin. Most of the gram-negative organisms were susceptible to imipenem. Conclusion : Gram-positive organisms were more commonly isolated than gram-negative organisms in pediatric cancer patients like other studies. We could obtained valuable information on the choice of proper antibiotics in our institution. Further studies will be needed to explain the prevalence of A. xylosoxidans in our center.
Keywords
Bacteremia; Antibiotics; Susceptibility; Child; Cancer;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Corapcioglu F, Sarialioglu F, Olgun N, Uysal KM. Analysis of 136 febrile neutropenic episodes in children with cancer: Evaluation of treatment effectiveness and cost. Pediatr Hematol Oncol 2004;21:533-41   DOI   ScienceOn
2 Wisplinghoff H, Seifert H, Wenzel RP, Edmond MB. Current trends in the epidemiology of nosocomial bloodstream infections in patients with hematological malignancies and solid neoplasms in hospitals in the United States. Clin Infect Dis 2003;36:1103-10   DOI   ScienceOn
3 Wang FD, Lin ML, Liu CY. Bacteremia in patients with hematological malignancies. Chemotherapy 2005;51:147-53   DOI   ScienceOn
4 Tenover FC, Weigel LM, Appelbaum PC, McDougal LK, Chaitram J, McAllister S, et al. Vancomycin-resistant Staphylococcus aureus isolate from a patient in Pennsylvania. Antimicrob Agents Chemother 2004;48:275-80   DOI   ScienceOn
5 Chao HC, Chiu CH, Huang YC, Lin TY, Su WJ. Endocarditis due to Neisseria sicca: report of one case. Chung-Hua Min Kuo Hsiao Ko I Hsueh Hui Tsa Chih 1997;38: 229-31
6 Berman MM, Gagnon D, Doern GV. Pichia ohmeri fungemia. Diagn Microbiol Infect Dis 1998;30:229-31   DOI   ScienceOn
7 Otag F, Kuyucu N, Erturan Z, Sen S, Emekdas G, Sugita T. Outbreak of Pichia ohmeri infection in the paediatric intensive care unit : case reports and review of the literature. Mycoses 2005;48;265-9   DOI   ScienceOn
8 Riquelme AJ, Calvo MA, Guzman AM, Depix MS, Garcia P, Perez C, et al. Saccharomyces cerevisiae fungemia after Saccharomyces boulardii treatment in immunocompromised patients. J Clin Gastroenterol 2003;36:41-3   DOI   ScienceOn
9 Oie S, Kamiya A. Microbial contamination of antisepticsoaked cotton balls. Biol Pharm Bull 1997;20:667-9   DOI
10 Ramphal R. Changes in the etiology of bacteremia in febrile neutropenic patients and the susceptibilites of the currently isolated pathogens. Clin Infect Dis 2004;39:S25-31   DOI
11 Aisenberg G, Rolston KV, Safdar A. Bacteremia caused by Achromobacter and Alcaligenes species in 46 patients with cancer(1989-2003). Cancer 2004;101:2134-40   DOI   ScienceOn
12 Chang S, Sievert DM, Hageman JC, Boulton ML, Tenover FC, Downes FP, et al. Infection with vancomycin-resistant Staphylococcus aureus containing the vanA resistance gene. N Engl J Med 2003;348:1342-7   DOI   ScienceOn
13 Oppenheim BA. The changing pattern of infection in neutropenic patients. J Antimicrob Chemother 1998;41:S7-11   DOI   ScienceOn
14 Schiappa DA, Hayden MK, Matushek MG, Hashemi FN, Sullivan J, Smith KY, et al. Ceftazidime-resistant Klebsiella pneumoniae and Escherichia coli bloodstream infection : a case-control and molecular epidemiologic investigation. J Infect Dis 1996;174:529-36   DOI   ScienceOn
15 Kacica M, McDonald LC. Brief report : vancomycin-resistant Staphylococcus aureus-New York, 2004. MMWR 2004; 53:322-3
16 Karlowsky JA, Jones ME, Draghi DC, Thornsberry C, Sahm DF, Volturo GA. Prevalence and antimicrobial susceptibilities of bacteria isolated from blood cultures of hospitalized patients in the United States in 2002. Ann Clin Microbiol Antimicob 2004;3:7   DOI   ScienceOn
17 Hughes WT, Armstrong D, Bodey GP, Bow EJ, Brown AE, Calandra T, et al. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis 2002;34:730-51   DOI   ScienceOn
18 Lai HP, Hsueh PR, Chen YC, Lee PI, Lu CY, Lu MY, et al. Bacteremia in hematological and oncological children with febrile neutropenia: experience in a tertiary medical center in Taiwan. J Microbiol Immunol Infect 2003;36:197- 202
19 Gonzalez-Barca E, Fernandez-Sevilla A, Carratala J, Granena A, Gudiol F. Prospective study of 288 episodes of bacteremia in neutropenic cancer patients in a single institution. Eur J Clin Microbiol Infect Dis 1996;15:291-6   DOI
20 Lee SL, Kim JS, Kim HS, Kang CM. A study on infection in childhood acute leukemia. Korean J Infect Dis 1990;22: 33-41
21 Fiore NF, Conway JH, West KW, Kleiman MB. Saccharomyces cerevisiae infections in children. Pediatr Infect Dis J 1998;17:1177-9   DOI   ScienceOn
22 Cesaro S, Chinello P, Rossi L, Zanesco L. Saccharomyces cerevisiae fungemia in a neutropenic patient treated with Saccharomyces boulardii. Support Care Cancer 2000;8:504-5   DOI   ScienceOn
23 Duggan JM, Goldstein SJ, Chenoweth CE, Kauffman CA, Bradley SF. Achromobacter xylosoxidans bacteremia : report of four cases and review of the literature. Clin Infect Dis 1996;23:569-76   DOI   ScienceOn
24 Streit JM, Jones RN, Sader HS, Fritsche TR. Assessment of pathogen occurrences and resistance profiles among infected patients in the intensive care unit : report from the SENTRY antimicrobial surveillance program(North America, 2001). Int J Antimicrob Agents 2004;24:111-8   DOI   ScienceOn
25 Tsay RW, Lin LC, Chiou CS, Liao JC, Chen CH, Liu CE, et al. Alcaligenes xylosoxidans bacteremia : clinical features and microbiological characteristics of isolates. J Microbiol Immunol Infect 2005:194-9
26 Kang CI, Kim SH, Park WB, Lee KD, Kim HB, Kim EC, et al. Bloodstream infections due to extended-spectrum ${\beta}$- lactamase-producing Escherichia coli and Klebsiella pneumoniae : risk factors for mortality and treatment outcome, with special emphasis on antimicrobial therapy. Antimicrob Agents Chemother 2004;48:4574-81   DOI   ScienceOn
27 Kim YH, Lee HD, Hah JO. Bacteremia in pediatric cancer patients : Causative organisms and antibiotic sensitivities. Korean J Pediatr 2005;48:619-23
28 Gilrane T, Tracy JD, Greenlee RM, Schelpert JW 3rd, Brandstetter RD. Neisseria sicca pneumonia. Report of two cases and revieww of the literature. Am J Med 1985;78: 1038-40   DOI   ScienceOn
29 Gomez-Cerezo J, Suarez I, Rios JJ, Pena P, Garcia de Miguel MJ, de Jose M, et al. Achromobacter xylosoxidans bacteremia : a 10-year analysis of 54 cases. Eur J Clin Microbiol Infect Dis 2003;22:360-3   DOI
30 Nordmann P, Poirel L. Emerging carbapenemases in gramnegative aerobes. Clin Microbiol Infect 2002;8:321-31   DOI   ScienceOn
31 Lautenbach E, Patel JB, Bilker WB, Edelstein PH, Fishman NO. Extended-spectrum ${\beta}$-lactamase-producing Escherichia coli and Klebsiella pneumoniae : risk factors for infection and impact of resistance on outcomes. Clin Infect Dis 2001;32:1162-71   DOI   ScienceOn
32 Martino R, Martinez C, Pericas R, Salazar R, Sola C, Brunet S, et al. Bacteremia due to glucose non-fermenting Gram-negative bacilli in patients with hematological neoplasias and solid tumors. Eur J Clin Microbiol Infect Dis 1996:610-5
33 Paterson DL, Ko WC, Von Gottberg A, Casellas JM, Mulazimoglu L, Klugman KP, et al. Outcome of cephalosporin treatment for serious infections due to apparently susceptible organisms producing extended-spectrum ${\beta}$-lactamases : implications for the clinical microbiology laboratory. J Clin Microbiol 2001;39:2206-12   DOI   ScienceOn
34 Lherm T, Monet C, Nougiere B, Soulier M, Larbi D, Le Gall C, et al. Seven cases of fungemia with Saccharomyces boulardii in critically ill patients. Intensive Care Med 2002; 28:797-801   DOI   ScienceOn
35 Zaoutis TE, Goyal M, Chu JH, Coffin SE, Bell LM, Nachamkin I, et al. Risk factors for and outcomes of bloodstream infection caused by extended-spectrum beta-lactamase- producing Escherichia coli and Klebsiella species in children. Pediatrics 2005;115:942-9   DOI   ScienceOn