Microbiological Spectrum and Susceptibility Patterns of Pathogens Causing Bacteraemia in Children with Malignancy-Associated Febrile Neutropenia at Mohammad Hoesin Hospital

Abstract

Febrile neutropenia is a devastating complication that can develop in cancer patients following chemotherapy. Bacterial infection is one of the leading causes of febrile neutropenia. The prompt administration of appropriate antibiotics significantly influences patients’ outcomes. Each institution's antibiotic regulations determine the initial antibiotic therapy for febrile neutropenia. This study purpose to identify the antibiotic susceptibility of the bacterial etiology in children with febrile neutropenia-associated malignancy at Mohammad Hoesin Hospital from 2020 to 2022. This 2020–2022 observational descriptive study used secondary data from the Mohammad Hoesin Hospital Medical Record and Central Laboratory Installation. In 2020-2022, the prevalence of neutropenia fever was 19.1%, with 366 incidents mostly occurring in males (56.3%), age groups 2 – <6 years (35%), and diagnosed with ALL (49.2%). The most frequently isolated bacterial group was  Gram-positive bacteria (52.3%). Among the gram-positive bacteria, the dominant pathogen was  CoNS (35.6%), while in the gram-negative group was  Klebsiella pneumoniae (11.4%). Isolates of CoNS have the most significant level of resistance to benzylpenicillin (100%) and are most susceptible to linezolid and tigecycline (100%). Klebsiella pneumoniae isolates exhibit complete resistance to cefazoline and ampicillin (100%) and are highly susceptible to tigecycline (100%). The predominant isolates detected in patients with febrile neutropenia were CoNS dan Klebsiella pneumoniae. Vancomycin and amikacin is effective against both CoNS and Klebsiella pneumoniae, indicating that it can be used as a first treatment for febrile neutropenia in paediatric cancer patients.