| Abstract [eng] |
Introduction: In recent decades, the survival of children with oncological diseases has been increasing, but the risk of infection due to treatment-induced neutropenia remains. All oncology treatment centers must monitor local flora and changes in its sensitivity to antibacterial agents. The aim of this study was to analyze the causative agents of bacteremia and their in vitro sensitivity to antibiotics. Methodology: A descriptive statistical analysis of data on bacteremia causative agents and their antibiotic resistance in vitro was performed retrospectively for the years 2017-2021 at the Children's Oncology and Hematology Department and Bone Marrow Transplantation Unit of Vilnius University Hospital Santaros Klinikos. The distribution of Gram-positive and Gram-negative bacteremia causative agents and their sensitivity to antibacterial therapy was compared between neutropenia groups and departments using Pearson's Chi-square and Fisher's exact tests. Results: Out of the 194 isolated bacteremia causative agents, two-thirds were Gram-positive (66.5%), and one-third were Gram-negative cultures (33.0%). The most commonly identified bacteremia causative agents were coagulase-negative staphylococci (37.6%), Escherichia coli (10.3%), Staphylococcus aureus (7.2%), and Klebsiella (7.2%) cultures. All tested Gram-positive strains were sensitive to linezolid (100%), most to vancomycin (96.4%), and teicoplanin (86.2%). 7.1% of Gram-negative bacteremia causative agents were resistant to imipenem, and 3.6% were resistant to meropenem. 50.0% of Pseudomonas aeruginosa cultures were resistant to carbapenems, and 35.7% of Klebsiella cultures were resistant to piperacillin-tazobactam. Among Gram-negative bacteremia causative agents, 12.5% were broad-spectrum β-lactamase-producing strains, and 6.3% were carbapenem-resistant strains. The distribution of Gram-positive and Gram-negative bacteremia causative agents did not significantly differ depending on the neutrophil count or between departments (p=0.8065 and p=0.1124, respectively). A statistically significant difference in the sensitivity of Gram-positive strains to gentamicin (p=0.0436) and vancomycin (p=0.0062) was found between departments. Conclusions: Two-thirds of bacteremia causative agents were Gram-positive, and one-third were Gram-negative cultures. Most Gram-positive cultures were sensitive to glycopeptides and linezolid, with the majority of coagulase-negative staphylococci being methicillin-resistant. Resistance to carbapenems was found in one-tenth of Enterobacter and half of Pseudomonas aeruginosa cultures, and one-third of Klebsiella cultures were resistant to β-lactam antibiotics. Differences in the sensitivity of Gram-positive cultures to gentamicin and vancomycin were found between departments. |
