Types of bacteria among pediatric oncology patients in Basra

Abstract

Background: Infectious agents are the main factor that causes children suffering from cancer to be more susceptible
to treatment failure. They complicate their course of therapy, thus shortening their lives. Aim: To find out the most
notorious pathogen affecting pediatric malignancy in Basra Children Specialty Hospital to provide the best
antimicrobial therapy choice and map out the future empirical therapy. Methods: One hundred and ten pediatric
oncology patients in the pediatric hemato-oncology unit aged 16 years and less were involved in this retrospective
study from March 1, 2021 to the end of February 2022. Different types of culture tests were taken in various stages
of malignancy besides other investigations, including CBC, RFT, LFT and imaging. According to studies, these were
important, since they help to spot the infection even if the culture was negative. Results: Acute Lymphoblastic
Leukemia was the main malignancy involved in this study (42.7%). 73.6% of patients were aged 1–10 years, 58% were
male, 62% were from Basra, and almost 2/3rd of them were from the periphery. Gram-positive bacteria represented
55.5% of the cases; Staphylococcus hemolytic and Staphylococcus hominine were mainly found, followed by E. coli,
which was the major gram-negative bacteria, which seemed to manifest during induction and relapse stages. These
were more likely to have a different type of antibiotic resistance to ESBL, CRE, and MRSA. Conclusions: Pediatric
oncology patients with fever, neutropenia, and/or mucositis were more infected by gram-positive bacteria. The
presence of bacteremia tends to be more critical during induction and relapse stages, as this may increase fatality.
These deaths can be prevented using strict infection control measures, with the consequence of intimidating effect
of the development of antibiotic resistance for existing patients as well as future patients.