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[Microorganisms isolated from blood cultures and resistance profile in children with cancer and high-risk febrile neutropenia. Red PINDA, Chile, 2016-2021]. | LitMetric

AI Article Synopsis

  • Bacteremia is a significant health issue in cancer patients, especially those experiencing high-risk febrile neutropenia (HRFN), prompting this study to analyze blood cultures in children.
  • A study conducted from 2016 to 2021 examined 284 cases of HRFN, revealing that gram-negative bacilli (49.2%) and gram-positive cocci (43.8%) were the most common microorganisms, with viridans group Streptococci being the most prevalent.
  • There were notable changes in antimicrobial resistance, including increased resistance to third-generation cephalosporins and oxacillin, emphasizing the importance of monitoring these trends for effective treatment strategies.

Article Abstract

Unlabelled: Bacteremia is a major cause of morbidity and mortality in patients with cancer and episodes of high-risk febrile neutropenia (HRFN).

Objective: To identify the frequency of microorganisms isolated from blood cultures (BC) and their antimicrobial resistance (R) profile in children with HRFN, compared with the same data from previous studies of the same group.

Method: Prospective, multicenter, epidemiological surveillance study of microorganisms isolated from BC in patients under 18 years of age, from 7 PINDA network hospitals, between 2016 and 2021.

Results: 284 episodes of HRFN with positive BC were analyzed out of 1091 enrolled episodes (26%). Median age 7.2 years [3.0-12.3]. The main isolates were gram-negative bacilli (GNB) 49.2%, gram-positive cocci (GPC) 43.8%, and fungi 3.6%. The most frequently isolated microorganisms were viridans group Streptococci (VGS) (25.8%), Escherichia coli (19.8%), Pseudomonas spp. (11.2%), Klebsiella spp. (10.9%), and coagulase negative Staphylococci (CoNS) (10.9%). There was an increase in R to third-generation cephalosporins (p = 0.011) in GNB and to oxacillin in CoNS (p = 0.00), as well as a decrease in R to amikacin in non-fermenting GNB (p = 0.02) and to penicillin in VGS (p = 0.04).

Conclusion: VGS is the main agent isolated in BC from pediatric patients with cancer and episodes of HRFN, followed by E. coli, Pseudomonas spp., and Klebsiella spp. Having epidemiological surveillance of microorganisms isolated from BC and their antimicrobial R profile is essential to favor the rational use of antimicrobials.

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Source
http://dx.doi.org/10.32641/andespediatr.v95i2.5012DOI Listing

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