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Supportive Care in Cancer
Published in: Supportive Care in Cancer 9/2013

01-09-2013 | Original Article

Bacteria causing bacteremia in pediatric cancer patients presenting with febrile neutropenia—species distribution and susceptibility patterns

Authors: Karin G. E. Miedema, Rik H. L. J. Winter, Roland A. Ammann, Sara Droz, Lodewijk Spanjaard, Eveline S. J. M. de Bont, Willem A. Kamps, Marianne D. van de Wetering, Wim J. E. Tissing

Published in: Supportive Care in Cancer | Issue 9/2013

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Abstract

Purpose

Infections are a major cause of morbidity and mortality in pediatric cancer patients. The aim of this study was to establish the microbiological spectrum and the susceptibility patterns of bacteremia-causing bacteria in pediatric cancer patients with febrile neutropenia in relation to the use of prophylactic and empirical antibiotics.

Methods

We analyzed positive blood cultures of pediatric cancer patients presenting with febrile neutropenia between 2004 and 2011 in Groningen and Amsterdam (the Netherlands) and in Bern (Switzerland), using different antibiotic prophylactic and empirical regimens.

Results

A total of 156 patients with 202 bacteremias, due to 248 bacteria species, were enrolled. The majority (73 %) of bacteremias were caused by Gram-positive bacteria. Gram-negative bacteria, especially Pseudomonas aeruginosa, were observed significantly more often in Bern, where no fluoroquinolone prophylaxis was used. Ciprofloxacin-resistant bacteria were cultured more often from patients who did receive ciprofloxacin prophylaxis, compared to the patients who did not (57 versus 11 %, p = 0.044).

Conclusions

Gram-positive bacteria predominated in this study. We showed that the use of prophylactic antibiotics in pediatric cancer patients was associated with increased resistance rates, which needs further study. The strategy for empiric antimicrobial therapy for febrile neutropenia should be adapted to local antibiotic resistance patterns.
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Metadata
Title
Bacteria causing bacteremia in pediatric cancer patients presenting with febrile neutropenia—species distribution and susceptibility patterns
Authors
Karin G. E. Miedema
Rik H. L. J. Winter
Roland A. Ammann
Sara Droz
Lodewijk Spanjaard
Eveline S. J. M. de Bont
Willem A. Kamps
Marianne D. van de Wetering
Wim J. E. Tissing
Publication date
01-09-2013
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 9/2013
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-013-1797-4

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