Bacteriological profile by blood culture among acute lymphoblastic leukemic children hospitalized with neutropenia and fever in a tertiary level hospital, Bangladesh.

Abstract

Abstract:Bacterial infection is an important complication among children with cancer, who are under chemotherapy. Bacterimea may occur during chemotherapy, which is an invasive procedure and also due to reduced number of neutrophil count. The study was conducted in a tertiary level hospital, Bangabandhu Sheikh Mujib Medical University in Bangladesh from March to September 2010. The aim of this study was isolation and identification of bacteria from blood culture among children with febrile neutropenia who were under chemotherapy. Blood samples were collected from 30 febrile neutropenic children and culture was done by traditional culture method using Trypticase soy broth for primary culture. Out of 30 blood samples, culture were positive in 6(20%) and were negative in 24(80%) samples. Two third of the culture positive patients had absolute neutrophil count (ANC) less than 100 cells/cmm. The isolated organisms were Pseudomonas spp (33.3%) Staphylococcus aureus (33.3%), Esch. coli (16.7%) and Acinetobacter spp (16.7%). Amikacin, imipenem and meropenem were the most effective antibiotics having 100% sensitivity. Blood culture is essential to evaluate the febrile neutropenic children who were under chemotherapy.Key word: Antibiotics, Bangladesh, Blood culture, Febrile neutropenia.

Microbiological Identification of Bacteria with Leukemic Children

“…19,20 The percentage of gram negative bacteria is more than gram positive bacteria which represent 62(77.5%), 18(2.5%) respectively show in Table (1) and the p-value is 0.00 which represent significant. According to the study the result has slightly more incidents in males number were 45 while females number were 35 from the whole number of specimen was 80 patients and agreement with Marcotte (1), Muhammed, 2 Ahamed, 4 Martinez-Laperche, 7 Sevan 21 show in Table (2). During the last few decades have seen diagnosed with cancer in the survival of children with the 5-year survival rate approaching 80%.…”

“…19 In present study 35(43.8%) of 80 blood cultures were positive which is similar to other studies Eslami Nejad, 13 El-Mahallawy. 24 The most Gram positive bacteria was isolated is Staphylococcus aureus 13(16.2%) and the most gram negative bacteria from the total isolates is Escherichia coli 21(26.3%), Klebsiella pneumoniae 13 (16.2%), Pseudomonas aeruginosa 11(13.8%) from the total results 80(100.0%) these show in Table (3) and the result agreement with Ahmed, 4 Tezcan. 25 The p-value is 0.003, which is significant gram positive and gram negative bacteria in relation with multiple sample.…”

“…23 Also, the Table (2) appear the most age group gives positive result between (1 day-3 years) which represent 33(100.0%) this agreement with Ahamed. 4 The p-value is 0.326 which, is non-significant in 2-sided. In our study, the multiple samples were associated with 70.5% of positive result Hosseini.…”

“…25 The p-value is 0.003, which is significant gram positive and gram negative bacteria in relation with multiple sample. In Table (4) the antibiotic susceptibility of isolated most effects to Staphylococcus aureus is Vancomycin 12(92.3%), Gentamycin 7(53.8%), Clindamycin 6(46.2%), Ciprofloxacin 5(38.1%), Lincomycin 4(30.8%), Cefixime 4(30.8%) and the more resistance is Penicillin 7(53.8%), Ceftriaxone 6(46.2%), Cefotaxime 5(38.1%), Oxacillin 4(30.8%) which agree with Eslami Nejad. 13 The most antibiotic sensitive gram negative organism is Escherichia coli to Imipenem 18(85.7%), Amikacin 15(71.4%), Gentamycin 14(66.6%), Piperacillin/Tazobactam 10(47.6%) and Klebsiella pneumoniae sensitive to Imipenem 8(61.5%), Amikacin 7(53.8%), Gentamycin 7(53.8%), Piperacillin/Tazobactam 3(23.1%), pseudomonas aeruginosa sensitive to Amikacin 10(90.9%), Imipenem 9(81.8%), Gentamycin 9(81.8%).…”

“…3 Patients with previously untreatable illness may now receive therapy and survive, due to large advances have been done in the management of patients with cancers. 4 Most important reasons for morbidity and mortality in leukemia is bacterial infections. 5 A divers set of chromosomal and molecular changes originate in pediatric leukemia, most of proof are acquired not inherited as only 5% of leukemia are associated with inherited syndromes.…”