Increasing Antimicrobial Resistance Monitored in Surveillance Analysis of Blood Stream Infections in Febrile Neutropenic Pediatric Oncology Patients

Microbiological Profile of Blood Stream Infections in Febrile Neutropenic Patients at a Tertiary Care Teaching Hospital in Rishikesh, Uttarakhand

“…being the most common. Similar results were obtained in studies conducted by El-Mahallawy et al, Esbenshade et al, and Kokkayil et al [23][24][25]31 Among gram-positive bacteria, coagulase-negative staphylococci were the predominant isolates obtained in culture. Similar trend has also been reported by several other studies.…”

“…Similar findings have been reported by various authors from different parts of the world. 3,[20][21][22][23][24][25][26][27][28] However, there is no specific explanation for this finding. The most common age group of patients in this study was 0 to 10 years which is in agreement with the study conducted by Kamonrattana et al 28 More number of FN patients in our study, had underlying hematological as compared with nonhematological malignancies (solid tumors).…”

Changing Microbiological Pattern of Pediatric Febrile Neutropenia

“…The same has been echoed in the study by Mikulska et al [30], who found that a questionnaire based data obtained in 2011 reported predominance of Gram negative organisms compared to the published data between 2005-2011. It is also worth mentioning that the studies from developing countries such as India [12][13][14][21][22][23][24][25][26] have consistently demonstrated a predominance of Gram negative organisms, probably because of less use of central venous catheters. It is not only the predominant organism but their antibiotic sensitivity pattern that decide the choice of empirical antimicrobial therapy in children with FN.…”

“…Till the 1990s the predominant etiological organism of pediatric FN world over were Gram positive bacteria but during the first decade of the 21st century Gram positive organisms became more prevalent specially in the developing countries with CONS (coagulase negative Staphyloccus aureus) being the most frequently isolated agent. Again during the present decade there seems to be a re-emergence of Gram negative organisms, particularly multidrug resistant (MDR) [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. The same has been echoed in the study by Mikulska et al [30], who found that a questionnaire based data obtained in 2011 reported predominance of Gram negative organisms compared to the published data between 2005-2011.…”

“…Trimethoprim/sulfamethoxazole, amoxicillin/clavulanate and fluoroquinolones have been used as antibacterial prophylaxis in these children with success, but has been linked with the risk of emergence of antibiotic resistance [1]. Past several decades have witnessed substantial change in the bacterial etiology of pediatric febrile neutropenia ( Apart from the time period of study, the microbiology of febrile neutropenia is largely dependent on the regional differences based on socio-economic and healthcare developments [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Data from European Organization for Research and Treatment of Cancer (EORTC) during 1973-1994, reveals a decreasing incidence of Gram negative agents from 71% to 31% while Gram positive infection rose from 29% to 69% [28].…”