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    Infect Chemother. 2011 Apr;43(2):191-197. Korean.
    Published online Apr 30, 2011.
    https://doi.org/10.3947/ic.2011.43.2.191
    Copyright © 2011 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy
    Original Article

    Clinical Investigation of Bacteremia in Children with Hemato-Oncologic Diseases

    Eun Young Ko,1 Hyun-ju Kang,1 Hyo Jin Kwon,1 Ui Yoon Choi,1 Jae-Wook Lee,1 Dong-Gun Lee,2 Yeon-Joon Park,3 Nak-Gyun Chung,1 Bin Cho,1 Hack-Ki Kim,1 and Jin Han Kang1
      • 1Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
      • 2Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
      • 3Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
    • Correspondence to Jin Han Kang, M.D. Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea, 505, Banpo-dong, Seocho-gu, Seoul 137-701, Korea. Tel: +82-2-2258-2828, Fax: +82-2-537-4544, Email: kjhan@catholic.ac.kr
    Received August 16, 2010; Revised February 23, 2011; Accepted February 24, 2011.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Background

    The purpose of this study was to determine the spectrum of locally prevalent pathogens and their susceptibility patterns responsible for bacteremia in pediatric hemato-oncologic patients for empiric antimicrobial therapy.

    Materials and Methods

    A one-year retrospective study of pediatric hematooncologic patients with bacteremia in Seoul St. Mary's Hospital, the Catholic University of Korea, from April 2009 to March 2010 was conducted using previous medical records. The findings were compared with our previous data obtained from 2004 to 2006.

    Results

    Sixty-five episodes of bacteremia were recorded in 41 patients. Of them, 55 (84.6%) occurred in neutropenic and 10 (15.4%) in non-neutropenic patients. Gram-positive organisms were more commonly isolated than Gram-negative organisms (56.9% vs. 41.5%) in the following order: viridans streptococci (23.1%), Klebsiella pneumoniae (21.6%), coagulase-negative staphylococci (12.3%), Staphylococcus aureus (7.7%), Enterococcus faecium (7.7%). Susceptibility rates of viridans streptococci to penicillin, cefotaxime and vancomycin were 33.3%, 60% and 100%, and those of Enterobacteriaceae to amikacin, ceftazidime, piperacillin/ tazobactam and meropenem were 94.7%, 73.7%, 78.9%, and 100%, respectively. Compared to our previous data, infection still contributed towards a major fraction of mortality and morbidity in the management of patients with cancer. No differences in mortality rate were observed between isolated organisms from bacteremia.

    Conclusions

    Gram-positive organisms were more prevalent than Gram-negative organisms in our population. The monitoring of causative agents and antimicrobial resistance should be considered in therapeutic strategies of pediatric hemato-oncologic infection.

    Keywords
    Bacteremia; Antimicrobial susceptibility; Child; Neutropenia

    Figures

    Figure 1
    Percentage of Gram-positive, Gram-negative bacteria and fungus isolated from blood stream infections during years of 2004-2006 versus years of 2009-2010

    Tables

    Table 1
    Characteristics of 41 Pediatric Hemato-Oncologic Patients with Bacteremia

    Table 2
    Causative Organisms in 65 Episodes of Bacteremia Developed in Pediatric Hemato-Oncologic Patients with or without Neutropenia

    Table 3
    Causative Organisms in 65 Episodes of Bacteremia Developed in Pediatric Hemato-Oncologic Patients with or without Catheter

    Table 4
    Antimicrobial Susceptibility Patterns of the Gram-positive Bacterial Isolates

    Table 5
    Antimicrobial Susceptibility Patterns of the Gram-negative Bacterial Isolates

    Table 6
    Severe Morbidity and Mortality in Pediatric Hemato-Oncologic Patients

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    MeSH Terms
    Amikacin
    Bacteremia
    Cefotaxime
    Ceftazidime
    Child
    Enterobacteriaceae
    Enterococcus faecium
    Humans
    Klebsiella pneumoniae
    Korea
    Medical Records
    Neutropenia
    Penicillanic Acid
    Penicillins
    Retrospective Studies
    Staphylococcus aureus
    Thienamycins
    Vancomycin
    Viridans Streptococci
    Metrics
    Share
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