Microbiology, infection control and infection related outcome in pediatric patients in an oncology center in Eastern India: Experience from Tata Medical Center, Kolkata.
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Date
2014-10
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Abstract
CONTEXT: Infection is a major determinant in the outcome of patients with cancer. AIMS: The aim was to know the epidemiology and outcome of
patients with cancer in a cancer care center in Eastern India. SETTINGS AND DESIGN: Retrospective study of pediatric patients in Tata Medical
Center, Kolkata, India. Methods: Patients (n = 262) between the age group of 0 and 18 years were reviewed for infections and infection‑related
outcome (January to December 2013). STATISTICAL ANALYSIS: Modified Wald method was used to determine confidence interval of proportions.
RESULTS: Gram‑negative bacteria were found to be the most common cause of bloodstream infections (BSIs) (56.4%), followed by Gram‑positive
cocci (34.5%), and Candida species (9.1%). Carbapenem‑resistance was noted among 24% of Gram‑negative bacilli (GNB), and extended‑spectrum
beta‑lactamase among 64% of GNBs. A single case of Vibrio cholerae septicemia was also noted. No case of vancomycin‑resistant Enterococcus
was observed, whereas only two cases of methicillin‑resistant Staphylococcus aureus bacteremia (1/3 of all Staphylococcus aureus bacteremia)
were detected. Escherichia coli, followed by Klebsiella, Pseudomonas, and Acinetobacter were the predominant organisms detected in BSIs.
Among Candida spp. BSIs no resistance to caspofungin, amphotericin B, Voriconazole was noted. Candida tropicalis was the most common
isolate, and 1 isolate of Candida glabrata showed dose‑dependent sensitivity to fluconazole. Three out of 25 patients died of multi‑drug resistant
Gram‑negative bacteria (12%) in 2013. Seventeen patients had radiological evidence of invasive fungal infections (no mortality was noted).
CONCLUSIONS: Periodic review of infection‑related data, as well as infection control practices, is essential to optimize clinical outcome in patients
with pediatric malignancies.
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Keywords
Antibiotic resistance, blood stream infections, infections, infections, Pediatric Oncology
Citation
Bhattacharyya Arpita, Krishnan Shekhar, Saha Vaskar, Goel Gaurav, Bhattacharya Sanjay, Hmar Lalawmpuia. Microbiology, infection control and infection related outcome in pediatric patients in an oncology center in Eastern India: Experience from Tata Medical Center, Kolkata. Indian Journal of Cancer. 2014 Oct-Dec; 51(4): 415-417.