Bloodstream Infections in Paediatric Cancer Patients with Febrile Neutropenia in a Tertiary Cancer Centre in North-East India

Abstract

Background: The aim of the present study was to study the pattern of microbial flora, their susceptibility patterns, and clinical variables among bloodstream infections in febrile neutropenic patients with solid tumors and hematological malignancies in the paediatric age group in North-East India. Methods: It was a retrospective and observational study done in a single tertiary care cancer centre in North-East India. The study period was from 1st January 2020 to 31st December 2021. The study population included all the patients below the age of 18 years who developed febrile neutropenia during treatment for a diagnosed cancer. Results: A total of 378 blood culture samples were studied. Febrile neutropenia was found in 252 patients (66.7%). There were 45 positive blood cultures (17.8%) among them. Gram-negative and gram-positive organisms accounted for 62% and 38% of all positive cultures respectively. Escherichia coli (39%) was the most common gram-negative isolate, followed by Klebsiella pneumoniae (32%), Pseudomonas aeruginosa (18%) and Acinetobacter baumannii (7%). Coagulase-negative Staphylococci (CoNS) was the most common gram-positive isolate (47%). Sensitivity to beta-lactam/beta-lactamase inhibitor (BL/BLI) antibiotics like cefaperazone/sulbactam was seen in 60% of Pseudomonas isolates. Sensitivity to colistin was noted in 89% of Klebsiella and 82% of E. coli isolates. The incidence of methicillin resistant staphylococcus aureus (MRSA) was 50%. Conclusion: The knowledge of the microbiological profile and resistance patterns among patients treated for paediatric cancer with febrile neutropenia is a key factor in deciding the antimicrobial policy.

Keywords

• febrile neutropenia, paediatric cancer, antimicrobial resistance, haematological malignancies, bloodstream infection