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Viridans group Streptococcus (VGS) is a leading cause of bacteremia in pediatric oncology patients, primarily in children with acute myeloid leukemia or after hematopoietic stem cell transplantation. We retrospectively identified all positive blood cultures in oncology patients at the British Columbia Children’s Hospital for a period of 54 months. VGS was the second most commonly isolated pathogen, present in 19% of all the positive blood cultures. Susceptibility analysis of 46 VGS isolates from that period was performed using the Etest method for penicillin, cefotaxime, ceftazidime, and piperacillin/tazobactam. The geometric mean minimal inhibitory concentration for ceftazidime was found to be 9 to 12-fold higher than for any other beta-lactam antibiotic. Penicillin resistance was of 13% with an additional 20% of samples with intermediate susceptibility. The study underscores the prevalence of VGS bacteremia in pediatric patients, especially with acute myeloid leukemia or postallogeneic hematopoietic stem cell transplantation, and the in vitro inferiority of ceftazidime compared with other beta-lactams in that context. We conclude that monotherapy with ceftazidime, or its use along with an aminoglycoside, is not an optimal therapy in pediatric oncology patients with febrile neutropenia.

Original publication

DOI

10.1097/mph.0b013e31819a5d40

Type

Journal article

Journal

Journal of pediatric hematology/oncology

Publication Date

04/2009

Volume

31

Pages

267 - 269

Addresses

Division of Immunological, Infectious Diseases, Department of Paediatrics, British Columbia Children’s Hospital, Vancouver, BC, Canada. scfpaulus@gmail.com

Keywords

Humans, Viridans Streptococci, Bacteremia, Streptococcal Infections, Cefotaxime, Ceftazidime, Penicillins, Penicillanic Acid, Piperacillin, Aminoglycosides, Anti-Bacterial Agents, Drug Therapy, Combination, Microbial Sensitivity Tests, Retrospective Studies, beta-Lactam Resistance, Child, Leukemia, Myeloid, Acute, In Vitro Techniques