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Gram-negative infections exhibited higher multidrug resistance among pediatric cancer patients
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MEMPHIS, Tenn. — Gram-negative bacteremia had a higher proportion and prevalence of multidrug-resistance compared with gram-positive bacteremia among pediatric cancer patients, according to data presented at the St. Jude/PIDS Pediatric Infectious Diseases Research Conference.
While MDR bacteremia represents a possible emerging threat to pediatric cancer patients, there is little evidence available depicting the burden of this disease, particularly in low- and middle-income countries.
Researcher Elizabeth C. Bittner, from the department of epidemiology and cancer control at St. Jude Children’s Research Hospital, and colleagues examined all episodes of febrile neutropenia (n = 216) among patients (n = 141) admitted to the hematology/oncology unit of Hospital Infantil de México Federico Gómez in Mexico City from November 2009 to September 2010.
“We used a very specific definition to determine multidrug-resistant bacteremia. To be termed ‘resistant,’ the bacteremia had to show resistance to one antibiotic in at least three antibiotic classes,” Bittner told Infectious Diseases in Children. “The definitions of multidrug resistance have varied significantly which has often made comparing data very difficult in low- and middle-income countries.”
The researchers also examined the gram-specific prevalence and proportion of MDR bacteremia with matching cluster-adjusted 95% confidence limits. The data showed that the overall prevalence of MDR gram-negative bacteremia was 1.8% (95% CL, 0.69%-4.8%) compared with gram-positive bacteremia at 0.46% (95% CL, 0.06%-3.3%). Additionally, the overall proportion of MDR gram-negative bacteremia was significantly higher at 17% (95% CL, 6.2%-40%) vs. gram-positive at 4.3% (95% CL, 0.55%-27%).
“Following our analysis, we found that gram-negative bacteremia — across all subgroups and overall — had a higher proportion and prevalence of multidrug-resistance than gram-positive bacteremia,” Bittner said. “This is an emerging problem and antimicrobial stewardship should be considered to prevent the increase of multidrug-resistance, particularly programs that facilitate appropriate antibiotic use and prescription.” – by Bob Stott
Reference:
Bittner EC, et al. Abstract R201507. Presented at: St. Jude/PIDS Pediatric Infectious Diseases Research Conference; Feb. 20-21, 2015; Memphis, Tennessee.
Disclosure: The researchers report no relevant financial disclosures.