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KMID : 0387820080150020065
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Clinical Pediatric Hematology-Oncology
2008 Volume.15 No. 2 p.65 ~ p.74
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A Survey for Causative Organisms and Antimicrobial Susceptabilities of Bacteremia in a Single Center Children with Hemato-Oncologic Diseases (2004∼2006)
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Lee Hye-Jin
Jeong Chang-Mo
Kang Jin-Han
Kim Hack-Ki
Chung Nack-Gyun
Cho Bin
Lee Dong-Gun
Kim Jong-Hyun
Lee Soon-Ju
Lee Jae-Wook
Lee Kwang-Hee
Lee Myeung-Ja
Choi Sun-Hee
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Abstract
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Purpose: We elucidated the causative organisms and antimicrobial susceptibility patterns in pediatric hemato-oncological patients with bacteremia to make a guideline for the empiric antimicrobial therapy.
Methods: A retrospective survey of the pediatric hemato-oncological patients with bacteremia in Saint Mary’s Hospital, the Catholic University of Korea, from January 2004 to December 2006 was performed with medical records.
Results: There were 138 episodes of culture proven bloodstream infections in 104 patients. Among the isolated 138 pathogens, 63 (45.6%) were gram-negative and 65 (47.1%) were gram-positive bacteria. Coagulase-negative staphylococci (n=26, 19.6%), Pseudomonas species (n=24, 17.4%), Klebsiella species (n=13, 9.4%) were the most common pathogens. Antimicrobial resistance rates in gram-positive bacteria to penicillin, oxacillin and vancomycin were 67.7%, 43.1%, and 13.8%, respectively, and those of gram-negative bacteria to ceftriaxone, piperacillin/tazobactam and imipenem were 28.6%, 9.5%, and 15.9%, respectively. Gram-negative organisms were more often associated with bacteremia in intensive care than gram-positive organisms (11.1% vs 5.1%, P＜0.001). And gram-negative bacteremic patients had a more fatal course during neutropenic periods (24.3% vs 14.8%, P= 0.007).
Conclusion: A shift from gram-negative to gram-positive bacteremia in the causative organisms of bloodstream infections has been occurring in hemato-oncologcal patients, recently. However, patients with gram-negative bacteremia had a more fatal course than those with gram-positive one in neutropenic period. These facts should be taken into consideration during management of pediatric hemato-oncological patients with infectious complications. Gram-negative, Hemato-oncological patients, Children.
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KEYWORD
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Bacteremia, Antimicrobial susceptibility, Causative organism, Gram-positive, Gram-negative, Hemato-oncological patients, Children
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