Comparison of isolates and antibiotic sensitivity pattern in pediatric and adult cancer patients; is it different?

Infection is a common cause of mortality and morbidity in cancer patients. Organisms are becoming resistant to antibiotics; age appears to be one of the factors responsible. We analyzed common organisms and their antibiotic sensitivity pattern in the correlation with age. This is a single institutio...

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Published in:	Indian journal of cancer Vol. 51; no. 4; p. 496
Main Authors:	Prabhash, K, Bajpai, J, Gokarn, A, Arora, B, Kurkure, P A, Medhekar, A, Kelkar, R, Biswas, S, Gupta, S, Naronha, V, Shetty, N, Goyel, G, Banavali, S D
Format:	Journal Article
Language:	English
Published:	India Medknow Publications and Media Pvt. Ltd 01-10-2014 Medknow Publications & Media Pvt. Ltd
Subjects:	Acinetobacter - drug effects Acinetobacter - isolation & purification Adolescent Adult Adults Age Factors Age groups Analysis Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Antibiotics Antimicrobial agents Bacterial infections Bacterial Infections - drug therapy Bacterial Infections - microbiology Bacteriology Cancer Cancer patients Cancer therapies Care and treatment Catheters Child Disk Diffusion Antimicrobial Tests Drug resistance Drug Resistance, Bacterial E coli Enterococcus - drug effects Enterococcus - isolation & purification Escherichia coli - drug effects Escherichia coli - isolation & purification Fluids Hospitals Humans Infection Klebsiella - drug effects Klebsiella - isolation & purification Mortality Neoplasms - complications Oncology Organisms Palliative care Pediatric pharmacology Pediatrics Pseudomonas aeruginosa - drug effects Pseudomonas aeruginosa - isolation & purification Retrospective Studies Software Staphylococcus aureus - drug effects Staphylococcus aureus - isolation & purification Staphylococcus infections Streptococcus - drug effects Streptococcus - isolation & purification Streptococcus infections Surveillance Teenagers Trends
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Summary:	Infection is a common cause of mortality and morbidity in cancer patients. Organisms are becoming resistant to antibiotics; age appears to be one of the factors responsible. We analyzed common organisms and their antibiotic sensitivity pattern in the correlation with age. This is a single institutional, retrospective analysis of all culture positive adult and pediatric cancer patients from January 2007 to December 2007. For statistical analysis, Chi-square test for trend was used and P values were obtained. Of 1251 isolates, 262 were from children <12 years of age and 989 were from adolescents and adults (>12 years of age). Gram-negative organisms were predominant (64.95) while Gram-positive constituted 35.09% of isolates. The most common source in all age groups was peripheral-blood, accounting to 47.8% of all samples. The most common organisms in adults were Pseudomonas aeruginosa (15.3%) while in children it was coagulase negative Staphylococcus aureus (19.8%). Antibiotic sensitivity was different in both groups. In pediatric group higher sensitivity was seen for Cefoparazone-sulbactum, Cefipime, Amikacin, and Tobramycin. No resistance was found for Linezolid. The isolates in both children and adults were predominantly Gram-negative though children had proportionately higher Gram-positive organisms. High-dose cytarabine use, cotrimoxazole prophylaxis, and frequent use of central lines in children especially in hematological malignancies could explain this observation. Children harbor less antibiotic resistance than adults; Uncontrolled, cumulative exposure to antibiotics in our community with increasing age, age-related immune factors and variable bacterial flora in different wards might explain the higher antibiotic resistance in adults. Thus age is an important factor to be considered while deciding empirical antibiotic therapy.
ISSN:	0019-509X 1998-4774
DOI:	10.4103/0019-509X.175356