Blood cultures in pediatric oncology, epidemiology 2023 of the National Oncology Institute - Solca Guayaquil.

Abstract

Introduction: Infections represent one of the primary complications in pediatric oncology. Ongoing monitoring of the microorganisms involved and their susceptibility to antibiotics has become as crucial as their rational use in preventing the emergence of resistance. The objective of this study was to utilize these data to establish an efficient and effective initial empirical management protocol.

Methodology: The results of blood cultures taken from febrile neutropenic children hospitalized in the Pediatric Department of the National Oncology Institute, Solca, Guayaquil, throughout 2023 were analyzed. Cultures were collected directly from peripheral blood samples, while retrospective cultures were obtained from samples taken from a central catheter or an implantable venous catheter. The institution's microbiology department identified the microorganisms and their sensitivities.

Results: A total of 831 cultures were collected during the study period, with 146 positive results (17.5%). Bacteria were identified in 84 cases (57%), while fungi were identified in 62 (43%). Among the bacteria, 44% were gram-positive, and 56% were gram-negative. The results were compared with those from previous years. The primary microorganisms isolated were gram-negative bacteria, with Klebsiella pneumoniae being the most frequently identified. Among the gram-positive bacteria, the majority were coagulase-negative staphylococci. The primary fungus isolated was Candida parapsilosis. No Aspergillus spp. were isolated.

Conclusions: Blood culture sensitivity was 17.5%, with Klebsiella identified as the most common organism. KPC and ESBL levels decreased, but Candida levels persisted. Vancomycin was administered in specific cases and at the onset of managing severe sepsis with an unknown pathogen.