Pattern of Bacterial and Fungal Infections in Neutropenic Pediatric Patients

Backgrounds: Neutropenia ca n be associated with lifethreaten ing infections. Gram negative and staphylococcal infections are the most common pathoge ns. The spectrum of bacterial isolates has changed co nsiderably over the past four decades, The objective of the prese nt study was to evaluate the pattern of bacterial and funga l infections in neutropenic pediatr ic patients. Methods: A non-randomized descriptive and cross-sectional study invo lving 100 hospit al ized children was carried out at the emerge ncy and pediatric hematology and oncology units of hospitals affi liated to Mashhad University of Med ical Sciences from September 2004 to September 2005 , Neutropenic children younger than 12 years o ld with clini cal sig ns of infection and/or feve r were enro lled in the study. Results: The study co mprised of 100 febrile and/or infected neutropenic episo des occ urring in 57 male and 43 female children younger than 12 years old with a mean age of 4.55±3.33 years. A total of 87 pathogens were cultured: 37 (42.5%) from urinary tract and 50 (57.5%) from other sites; 54 (62. 1%) were gram-negative bacteria, 2 1 (24 .1%) were gram -pos itive bacteria, and 12 ( 13 .8%) were fungus. Pseudomonas aerugi nosa and staphylococc us aureus were the most frequent gramnegat ive and gram-positive isolates respect ively. Candida sp p. was the only isolated fungus. Acute lymph oblastic leukemia was the most common disease encompass ing 33% of all cases. Conclusion : As the pattern s of isolates in neutropen ic patients are not the same in different parts of the world and gramnegative organisms were still the most common pathogens isolated in our study populat ion, thera peutic adj ustments for empirica l antib iotic therapy are likely to be focused on gramnegativ e pathogens.