Antibiotic susceptibility of Gram-negatives isolated from bacteremia in children with cancer. Implications for empirical therapy of febrile neutropenia

Diabetic foot infections (DFIs) are a significant health issue and a common complication among patients with diabetes. To develop antibiotic therapy for these high-risk patients, the current study evaluates the scope of DFIs and identifies the causing microbes. It also measures spectrum and antibiotic susceptibility of the pathogens isolated from adults with DFIs in Saudi Arabia. To achieve the study objectives, a cross-sectional study was implemented and the baseline characteristics for 44 patients with DFIs were defined. Optimal aerobic and anaerobic microbiological techniques were utilized to culture specimens isolated from infected foot ulcers. The standard microbiological methods were employed to identify the bacterial isolates and antibiotic susceptibility testing was conducted following the procedures of the Clinical and Laboratory Standards Institute (CLSI). Results showed that 12 microorganisms were isolated from the participants’ diabetic foot ulcers. Staphylococcus Aureus was ranked first because it appeared in 29 (65.9%) cases. Streptococcus Agalactiae was ranked second and multi-microbial infections were also found. Most of the organisms were susceptible to Vancomycin, Ciprofloxacin, and Cefalexin, but they were resistant to Methicillin, Gentamicin, and Ampicillin antibiotics. Staphylococcus Aureus was most sensitive to Ciprofloxacin, while it was resistant to Methicillin. About 10% of the isolates were multidrug-resistant. The study concludes that while Vancomycin should be used empirically for Gram-positive isolates, Ciprofloxacin can be taken into consideration for most of the Gram-negatives aerobes. Based on including various microorganisms and the advent of multidrug-resistant strains, proper culture and sensitivity testing are necessary prior to the empirical therapy.

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Oral ciprofloxacin in the management of children with cancer with lower risk febrile neutropenia

Cancer ◽

10.1002/1097-0142(20010415)91:8<1563::aid-cncr1166>3.0.co;2-c ◽

2001 ◽

Vol 91 (8) ◽

pp. 1563-1567 ◽

Cited By ~ 46

Author(s):

Hugo Paganini ◽

Teresa Rodriguez-Brieshcke ◽

Pedro Zubizarreta ◽

Antonio Latella ◽

Ver�nica Firpo ◽

...

Keyword(s):

Febrile Neutropenia ◽

Lower Risk ◽

Children With Cancer ◽

Oral Ciprofloxacin

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Time to First Dose of Antibiotics in Children with Cancer and Febrile Neutropenia. A Report from a Peruvian Hospital

10.29011/amco-133.000133 ◽

2021 ◽

Vol 4 (2) ◽

Keyword(s):

Febrile Neutropenia ◽

Children With Cancer

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Cost-effectiveness of home-based care of febrile neutropenia in children with cancer

10.22541/au.163251882.21756689/v1 ◽

2021 ◽

Author(s):

Michelle Tew ◽

Richard De Abreu Lourenco ◽

Joshua Gordon ◽

Karin Thursky ◽

Monica Slavin ◽

...

Keyword(s):

Cost Effectiveness ◽

Febrile Neutropenia ◽

Low Risk ◽

Hospital Treatment ◽

Decision Analytic Model ◽

Children With Cancer ◽

Patient Level ◽

Home Based ◽

Intravenous Antibiotics ◽

Home Based Care

INTRODUCTION Home-based treatment of low-risk febrile neutropenia (FN) in children with cancer with oral or intravenous antibiotics is safe and effective. There are limited data on the economic impact of this model of care. We evaluated the cost-effectiveness of implementing a low-risk FN program, incorporating home-based intravenous antibiotics, in a tertiary pediatric hospital. METHODS A decision analytic model was constructed to compare costs and outcomes of the low-risk FN program, with usual in-hospital treatment with intravenous antibiotics. The program included a clinical decision rule to identify patients at low-risk for severe infection and home-based eligibility criteria using disease, chemotherapy and patient-level factors. Health outcomes (quality-of-life) and probabilities of FN risk classification and home-based eligibility were based on prospectively collected data. Patient-level costs were extracted from hospital records. Cost-effectiveness was expressed as the incremental cost per quality-adjusted life year (QALY). FINDINGS The mean healthcare cost of home-based FN treatment in low-risk patients was A$7,765 per patient compared to A$20,396 for in-hospital treatment (mean difference A$12,632 (95% CI,12,496-12,767)). Overall, the low-risk FN program was the dominant strategy, being more effective (0.0011 QALY (95% CI,0.0011-0.0012)) and less costly. Results of the model were most sensitive to proportion of children eligible for home-based care program. CONCLUSION Compared to in-hospital FN care, the low-risk FN program is cost-effective, with savings arising from cheaper cost of caring for children at home. These savings could increase as more patients eligible for home-based care are included in the program.

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Cost‐effectiveness of home‐based care of febrile neutropenia in children with cancer

Pediatric Blood & Cancer ◽

10.1002/pbc.29469 ◽

2021 ◽

Author(s):

Michelle Tew ◽

Richard De Abreu Lourenco ◽

Joshua Robert Gordon ◽

Karin A. Thursky ◽

Monica A. Slavin ◽

...

Keyword(s):

Cost Effectiveness ◽

Febrile Neutropenia ◽

Children With Cancer ◽

Home Based ◽

Home Based Care

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Microbiological monitoring as a component of efficient prevention and treatment of purulent-septic infections in an orthopedics and traumatology department

Zaporozhye Medical Journal ◽

10.14739/2310-1210.2021.3.229667 ◽

2021 ◽

Vol 23 (3) ◽

pp. 381-387

Author(s):

N. M. Polishchuk ◽

D. L. Kyryk ◽

I. Ye. Yurchuk

Keyword(s):

Antibiotic Resistance ◽

Emergency Care ◽

Antibiotic Susceptibility ◽

Analytical Data ◽

Empirical Therapy ◽

Care Hospital ◽

Resistance Development ◽

E Coli ◽

Microbiological Monitoring ◽

Bacteriological Test

Efficient monitoring of circulating purulent-septic infectious agents in a clinical setting and a study on antibiotic susceptibility of isolated strains of microorganisms allows identifying changes in the pathogen structure and trends in antibiotic resistance development, which helps to determine the tactics of antibacterial therapy and elaborate appropriate measures. The aim of the study. Retrospective analysis of the results of microbiological monitoring of purulent-septic infectious (PSI) agents in the Orthopedics and Traumatology Department (OTD) of the Zaporizhzhia Central Ambulance and Emergency Care Hospital over the period 2017–2020 to determine the main antibacterial drugs for empirical therapy. Materials and methods. We analyzed the bacteriological test results of 664 clinical material samples obtained from OTD patients using bacteriological examination statistical reporting and analytical data of the WHONET 5.6 software. Results. The main PSI pathogens in the OTD were from the ESKAPE group: E. coli, S. aureus, K. pneumoniae, A. baumannii, E. faecalis, P. aeruginosa and S. epidermidis, P. mirabilis, C. amycolatum. Isolates of E. faecalis were sensitive to vancomycin, linezolid, S. aureus – to linezolid, tigecycline, netilmicin, A. baumannii – to tigecycline. All P. aeruginosa strains were resistant to ticarcillin/clavulanate, cefepime, chloramphenicol, imipenem, meropenem, aztreonam, ciprofloxacin. E. coli and K. pneumoniae were resistant to ampicillin, ticarcillin/clavulanate, aztreonam, ceftriaxone, cefepime. The number of isolates sensitive to piperacillin/tazobactam, carbapenems, levofloxacin, gentamicin, amikacin, chloramphenicol ranged from 37 % to 65 %. Conclusions. E. coli, S. aureus, K. pneumoniae, A. baumannii, E. faecalis, P. aeruginosa, S. epidermidis, P. mirabilis, C. amycolatum play an important role in the structure of PSI pathogens in the Orthopedics and Traumatology Department of Zaporizhzhia Central Ambulance and Emergency Care Hospital. The antibiotics of choice as the antibacterial empirical therapy for enterococcal infections are vancomycin, linezolid, for staphylococcal infections – vancomycin, linezolid, tigecycline, netilmicin. PSI pathogens continually evolve developing antibiotic resistance, and it is of particular importance to monitor antibiotic susceptibility of microorganisms within the OTD.

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