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

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 e...

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Main Authors: Ali Nateghian, Joan Robinson, P. Vosough, M. Navidinia, M. Malekanl, A. Mehrvar, B. Sobuti, Pooria Bahadoran, Z. Gholinejad
Format: Article
Language:English
Published: PAGEPress Publications 2014-06-01
Series:Mediterranean Journal of Hematology and Infectious Diseases
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Online Access:http://www.mjhid.org/index.php/mjhid/article/view/1390
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author Ali Nateghian
Joan Robinson
P. Vosough
M. Navidinia
M. Malekanl
A. Mehrvar
B. Sobuti
Pooria Bahadoran
Z. Gholinejad
author_facet Ali Nateghian
Joan Robinson
P. Vosough
M. Navidinia
M. Malekanl
A. Mehrvar
B. Sobuti
Pooria Bahadoran
Z. Gholinejad
author_sort Ali Nateghian
collection DOAJ
description 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.
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spelling doaj-art-7ca52fbb922a46e0b57b0a91d831fa942025-08-20T02:50:47ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062014-06-0161e2014045e201404510.4084/mjhid.2014.0451150COMPARISON 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, IRANAli Nateghian0Joan Robinson1P. VosoughM. Navidinia2M. Malekanl3A. Mehrvar4B. Sobuti5Pooria Bahadoran6Z. Gholinejad7Department of Pediatrics, Iran University of Medical Sciences, Tehran, IranUniversity of AlbertaPediatric Infections Research Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranPediatric Infections Research Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranMahak Hospital and Rehabilitation Complex, Tehran, IranMahak Hospital and Rehabilitation Complex, Tehran, IranAliasghar Children’s Hospital, Iran University of Medical Sciences, Tehran, IranPediatric Infections Research Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranInfection 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.http://www.mjhid.org/index.php/mjhid/article/view/1390Febrile neutropeniaMalignancyQuinolones
spellingShingle Ali Nateghian
Joan Robinson
P. Vosough
M. Navidinia
M. Malekanl
A. Mehrvar
B. Sobuti
Pooria Bahadoran
Z. Gholinejad
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
Mediterranean Journal of Hematology and Infectious Diseases
Febrile neutropenia
Malignancy
Quinolones
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Febrile neutropenia
Malignancy
Quinolones
url http://www.mjhid.org/index.php/mjhid/article/view/1390
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