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KMID : 0605820120190030131
Korean Journal of Pediatric Infectious Diseases
2012 Volume.19 No. 3 p.131 ~ p.140
Etiological Agents in Bacteremia of Children with Hemato-oncologic Diseases (2006-2010): A Single Center Study
Kang Ji-Eun

Seok Joon-Young
Yun Ki-Wook
Kang Hyoung-Jin
Choi Eun-Hwa
Park Kyung-Duk
Shin Hee-Young
Lee Hoan-Jong
Ahn Hyo-Seop
Abstract
Purpose : This study was performed to identify the etiologic agents and antimicrobial susceptibility patterns of organisms responsible for bloodstream infections in pediatric cancer patients for guidance in empiric antimicrobial therapy.

Methods : A 5-year retrospective study of pediatric hemato-oncologic patients with bacteremia in Seoul National University Children¡¯s Hospital, from 2006 to 2010 was conducted.

Results : A total of 246 pathogens were isolated, of which 63.4% (n=156) were gram-negative, bacteria 34.6% (n=85) were gram-positive bacteria, and 2.0% (n=5) were fungi. The most common pathogens were Klebsiella spp. (n=61, 24.8%) followed by Escherichia coli (n=31, 12.6%), coagulase-negative staphylococci (n=23, 9.3%), and Staphylococcus aureus (n=22, 8.9 %). Resistance rates of gram-positive bacteria to penicillin, oxacillin, and vancomycin were 85.7%, 65.9%, and 9.5%, respectively. Resistance rates of gram-negative bacteria to cefotaxime, piperacillin/tazobactam, imipenem, gentamicin, and amikacin were 37.2%, 17.1%, 6.2%, 32.2%, and 13.7%, respectively. Overall fatality rate was 12.7%. Gram-negative bacteremia was more often associated with shock (48.4% vs. 11.9%, P <0.01) and had higher fatality rate than gram-positive bacteremia (12.1% vs. 3.0%, P =0.03). Neutropenic patients were more often associated with shock than non-neutropenic patients (39.6 % vs. 22.0%, P =0.04).

Conclusion : This study revealed that gram-negative bacteria were still dominant organisms of bloodstream infections in children with hemato-oncologic diseases, and patients with gram-negative bacteremia showed fatal course more frequently than those with gram-positive bacteremia.
KEYWORD
Bacteremia, Pediatric cancer, Neutropenia, Fever
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