Antibiotic sensitivity/resistance pattern of hospital acquired blood stream infection in children cancer patients: A retrospective study.

Background: The literature shows a growing emphasis on understanding the local patterns of antimicrobial resistance (AMR). We aimed to evaluate the spectrum of local microorganisms that cause bloodstream infections (BSI) and their AMR patterns in an Egyptian institution treating children with cancer.

Methods: We conducted a single-centre, retrospective, study on children with confirmed primary, hospital-acquired, BSIs over one year. The microbiological examination of blood samples was done according to the Clinical and Laboratory Standards Institute. The antibiotic sensitivity test was done using VITEK® 2 system.

Results: We retrieved the data of 607 children with a median age of 5 (0.25-18) years old. The most encountered diagnosis was acute lymphoblastic leukaemia (40%). Most identified microorganisms were gram-negative bacilli, mainly Escherichia coli (27.8%), followed by Klebsiella pneumoniae (12.2%). Gram-negative bacilli showed high resistance to piperacillin/tazobactam, levofloxacin, and meropenem. The lowest resistance rates for Gram-negative bacilli isolates were noted for colistin and tigecycline. Similarly, the gram-positive cocci showed high resistance to ampicillin/sulbactam, cefoxitin, and clindamycin; and low resistance regarding vancomycin and linezolid.

Conclusion: Resistance proportions (pattern) were similar to those reported in other countries with a higher distribution of E coli and a growing resistance to levofloxacin. Further investigation of the predisposing factors and the development of more effective strategies for the prevention of BSI should be a significant public health priority.