Evaluation of Microbiologically Documented Bloodstream Infections in Pediatric Hematology/Oncology Patients: Results of Ten Years

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İşeri Küskü Z. A., Öksüz L., Öngen B., Karakaş Z.

XIII. Eurasian Hematology Oncology Congress, İstanbul, Turkey, 5 - 08 October 2022, vol.44, pp.25-26

  • Publication Type: Conference Paper / Full Text
  • Volume: 44
  • City: İstanbul
  • Country: Turkey
  • Page Numbers: pp.25-26
  • Istanbul University Affiliated: Yes


Objective: In pediatric hematology/oncology patients, infections are the main cause of prolonged hospital stay,increased mortality and high cost following relapse or progression. In this patient group, infections caused by multi-drug resistant bacteria are common and affect morbidity and mortality rates. We aimed to determine the frequency and antibiotic susceptibility of bacteria isolated from blood cultures of the patients with malignant and non-malignant diseases in our hospital over a ten-year period.

Methodology: patients admitted to the Pediatric Hematology/Oncology Service between January 2011- June 2021 were evaluated. The most common disease was acute lymphoblastic leukemia (27%). The first isolated bacteria of same

species for each patient were included, contaminated cultures were not included. Blood cultures incubated in the Bactec FX automated blood culture system for five days. Bacteria were identified by conventional methods or automated systems. Antibiotic susceptibility tests were performed by disc diffusion or gradient test and were evaluated according to guidelines.

Results: A total of 4631 blood culture samples from 296 patients were analyzed.Positive signal was seen in 620 samples. Blood culture posivity was 13.4%. Total 298 blood culture samples were evaluated. Gram positive bacteria rate were 59% and 41%gram  negative. The most frequently (58.7%) isolated gram positive bacteria were methicillin-resistant coagulase negative staphylococci and gram negative bacteria were Klebsiella pneumoniae (28,5%). The rate of bacteria producing extended spectrum beta lactamase (ESBL) was detected as 74% for Escherichia coli and 69% for Klebsiella pneumoniae.

Conclusion: It is important for each center to determine its own causative agents and their resistance patterns in bloodstream infections. Gram positive bacteria were found dominantly in our study. The high ESBL rate in E.coli and K.pneumoniae isolates is remarkable. Early detection of the causative agents in bloodstream infections of the pediatric hematology/oncology patients and initiation of prompt treatment are important to reduce mortality.