Microbiological Profiles and Resistance Patterns in Pediatrics With Cancer: An 8-Year Study at a Comprehensive Cancer Center in Jordan.

Introduction: Infections impact morbidity and mortality in pediatric cancer patients, yet limited studies have assessed the microbiological profiles and susceptibility patterns of pathogenic bacteria in this population. This study aimed to investigate bacterial profiles and temporal resistance changes in pediatrics with cancer.

Methods: We identified positive cultures between January 2015 and December 2022 for pediatric patients diagnosed with cancer at age < 18 years. Electronic records provided patient demographics, microbiological profiles and resistance patterns. Using "R" programming, the dataset was refined, selecting patients' first isolate within a 30-day period, and categorizing strains based on multidrug-resistant (MDR) and extensively drug-resistant (XDR) predefined criteria. Additionally, we analyzed changes in resistance patterns over the study period.

Results: Out of 1215 patients, 2992 bacterial isolates were reported, with 66% being Gram-negative bacteria. Urine was the most common site of infection, representing 48% of cases. Among these, 42% were MDR and 2% XDR. MDR prevalence was 45% for Escherichia coli, 21% for Klebsiella pneumonia, and 14% for Staphylococcus aureus. Acinetobacter baumannii and Pseudomonas aeruginosa displayed XDR at 79% and 21%, respectively. Methicillin-resistant S. aureus decreased from 71% in 2015 to 54% in 2022. MDR Klebsiella pneumonia peaked in 2021. MDR Pseudomonas aeruginosa decreased from 44% in 2015 to 16% in 2022.

Conclusion: Drug resistance was detected in 50% of the isolates with most being Gram-negative and MDR. Further research is needed to identify risk factors for resistance, aiming to refine empiric antimicrobial therapy.