Bacteriemia en pacientes oncológicos. Experiencia en un hospital pediátrico

Abstract

The use of intensive chemotherapy has improved survival of children with cancer. However, this is associated to severe and maintained neutropenia, increasing risks of severe infections like bacteremia. Aim: To update information on microorganisms involved in bloodstream infections in cancer patients and their antimicrobial resistance patterns during the last 3 years in our hospital, comparing it with our previous experience and with other Chilean centres. Material and Methods: Analysis of positive blood cultures belonging to cancer patients during 2006-2008 registered in the Microbiology Lab at the Roberto Del Rio Children's Hospital. Results: In 52 patients, 96 blood cultures yielded bacteria: 59.4% gram positive cocci and 34.4%, gram negative rods. Coagulase negative Staphylococci (CNS) were the most frequent bacteria isolated and enterobacteria were in the second place. Susceptibility to cloxacillin was 11% in CNS and 70 % in Staphylococcus aureus isolates. Enterobacteria maintained susceptibility to third generation cephalosporins and aminoglycosides. Conclusion: Despite the low sensitivity of CNS to cloxacillin, the empirical antibiotic treatment in our unit must include cloxacillin because of the high susceptibility of S. aureus. Switching to vancomycin should be considered only if SCN is isolated or there is an unfavorable evolution.