COMPARISON OF ANTIMICROBIAL SENSITIVITY TO OLDER AND NEWER QUINOLONES VERSUS PIPERACILLIN-TAZOBACTAM, CEFEPIME AND MEROPENEM IN FEBRILE PATIENTS WITH CANCER IN TWO REFERRAL PEDIATRIC CENTERS IN TEHRAN, IRAN

Ali Nateghian, Joan Robinson, P. Vosough, M. Navidinia, M. Malekanl, A. Mehrvar, B. Sobuti, Pooria Bahadoran, Z. Gholinejad
  • Ali Nateghian
    Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of | nateghian@hotmail.com
  • Joan Robinson
    University of Alberta, Canada
  • P. Vosough
    Affiliation not present
  • M. Navidinia
    Pediatric Infections Research Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of
  • M. Malekanl
    Pediatric Infections Research Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of
  • A. Mehrvar
    Mahak Hospital and Rehabilitation Complex, Tehran, Iran, Iran, Islamic Republic of
  • B. Sobuti
    Mahak Hospital and Rehabilitation Complex, Tehran, Iran, Iran, Islamic Republic of
  • Pooria Bahadoran
    Aliasghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of
  • Z. Gholinejad
    Pediatric Infections Research Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of

Abstract

Infection in pediatric cancer patients has become a concerning problem due to increasing antimicrobial resistance. The goal of this study was to determine the antimicrobial resistance patterns of blood isolates from pediatric oncology patients in Iran to determine if quinolones are appropriate for empiric therapy.

Methods

Children with cancer who were admitted with or developed fever during admission to Aliasghar Children’s Hospital or Mahak Hospitals July 2009 through June 2011 were eligible for enrollment. Two blood cultures were obtained.  Antimicrobial sensitivity test was performed for ciprofloxacin, moxifloxacin, gatifloxacin, meropenem, cefepime, and piperacillin-tazobactam on isolates from children who were bacteremic.

Results

Blood cultures were positive for 39 episodes in 169 enrolled children but 9 episodes were excluded as blood cultures were thought to be contaminated,  yielding a bacteremia rate of 29/160 (18%). The mean age of children and the stage of malignancy did not differ between those with and without bacteremia. Meropenem was the most likely antibiotic to cover isolates (97%) with cefepime having the lowest coverage rate (21%). Quinolone coverage ranged from 63%  to 76%.

Conclusion

Quinolones are not suitable for use as empiric therapy in febrile pediatric oncology patients in Iran.

Keywords

Febrile neutropenia; Malignancy; Quinolones

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Submitted: 2014-07-21 14:09:16
Published: 2014-06-29 00:00:00
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