Naema Salah Mohamed Elseady1, Nagwa Abdel Ghani Ahmed Khamis2, Sameh AbdelGhani3,4, Hoda Mohamed Rabea5, Mervat Gaber Elanany6, Khaled Nashat Alsheshtawi7, Mohamed Ea Abdelrahim5. 1. Infection Prevention and Control Unit, Children Cancer Hospital, 57357, Cairo, Egypt. 2. Department of Clinical Pathology, Ain Shams University, Cairo, Egypt. 3. Department of Microbiology and Immunology, Beni-Suef University, Beni-Suef, Egypt. 4. Department of Medicine, University of Louisville, KY 40202, USA. 5. Clinical Pharmacy Department, Beni-Suef University, Beni-Suef, Egypt. 6. Clinical Pathology Department Faculty of Medicine, Cairo University, Children Cancer Hospital, Microbiology unit, 57357, Cairo, Egypt. 7. Research Department, Children Cancer Hospital, Cairo, Egypt.
Abstract
BACKGROUND: The literature shows a growing emphasis on understanding the local patterns of antimicrobial resistance (AMR). We aimed to evaluate the spectrum of local microorganisms that cause bloodstream infections (BSI) and their antimicrobial resistance (AMR) patterns in an Egyptian institution treating children with cancer. METHODS: We conducted a single-center, retrospective, study on children with confirmed primary, hospital-acquired, BSIs over one year. The microbiological examination of blood samples was done according to the Clinical and Laboratory Standards Institute (CLSI). The antibiotic sensitivity test was done using VITEK® 2 system. RESULTS: We retrieved the data of 607 children with a median age of 5 (0.25 - 18) years old. The most encountered diagnosis was acute lymphoblastic leukemia (40%). Most identified microorganisms were gram-negative bacilli, mainly E. coli (27.8%), followed by Klebsiella pneumoniae (12.2%). Gram-negative bacilli showed high resistance to piperacillin/tazobactam, levofloxacin, and meropenem. The lowest resistance rates for Gram-negative bacilli isolates were noted for colistin and tigecycline. Similarly, the gram-positive cocci showed high resistance to ampicillin/sulbactam, cefoxitin, and clindamycin; and low resistance regarding vancomycin and linezolid. CONCLUSION: Resistance proportions (pattern) were similar to those reported in other countries with a higher distribution of E. coli and a growing resistance to levofloxacin. Further investigation of the predisposing factors and the development of more effective strategies for the prevention of BSI should be a significant public health priority. This article is protected by copyright. All rights reserved.
BACKGROUND: The literature shows a growing emphasis on understanding the local patterns of antimicrobial resistance (AMR). We aimed to evaluate the spectrum of local microorganisms that cause bloodstream infections (BSI) and their antimicrobial resistance (AMR) patterns in an Egyptian institution treating children with cancer. METHODS: We conducted a single-center, retrospective, study on children with confirmed primary, hospital-acquired, BSIs over one year. The microbiological examination of blood samples was done according to the Clinical and Laboratory Standards Institute (CLSI). The antibiotic sensitivity test was done using VITEK® 2 system. RESULTS: We retrieved the data of 607 children with a median age of 5 (0.25 - 18) years old. The most encountered diagnosis was acute lymphoblastic leukemia (40%). Most identified microorganisms were gram-negative bacilli, mainly E. coli (27.8%), followed by Klebsiella pneumoniae (12.2%). Gram-negative bacilli showed high resistance to piperacillin/tazobactam, levofloxacin, and meropenem. The lowest resistance rates for Gram-negative bacilli isolates were noted for colistin and tigecycline. Similarly, the gram-positive cocci showed high resistance to ampicillin/sulbactam, cefoxitin, and clindamycin; and low resistance regarding vancomycin and linezolid. CONCLUSION: Resistance proportions (pattern) were similar to those reported in other countries with a higher distribution of E. coli and a growing resistance to levofloxacin. Further investigation of the predisposing factors and the development of more effective strategies for the prevention of BSI should be a significant public health priority. This article is protected by copyright. All rights reserved.