Choice of empirical therapy and prophylaxis

MICROBIAL PATTERN AND ANTIBIOTIC SENSITIVITY TEST OF HOSPITALIZED CHILDREN

Infection often occurs in children with malignant hematology and causes morbidity and mortality in the children. Antibiotics given must be based on culture results and antibiotic sensitivity testing. This study was aimed to obtain the microbial pattern and sensitivity test in children hospitalized in the Hemato-Oncology Ward,  dr. Soetomo Hospital from September 2012 - February 2013. This was a descriptive study. Data were obtained from the  patients’ medical records  in Dr. Soetomo Hospital. There were 341 culture examinations (blood, urine, rectum swab, faecal, and others) from 88 patients (44 males and 44 females). Most of patients´ age was < 5 years (58%) and suffered from ALL (50%).There were microbial (83 of culture) and yeast (15 of culture) growth out of 98 cultures. Escherichia coli, Burkholderia cefacea, and Klebsiella oxytoca (Gram negative) dan CONS, Stapyloccocus aureus, and Stapylococcus sapropyticus (gram positive) were found in blood culture. S. aureus (gram positive) and E. coli, Klebsiella pneumoniae, and B. cefacea (gram negative) were found in urine culture. Only E. coli was found in rectal swab culture. CONS of gram positive cocci were mostly found in blood culture of children hospitalized in Hemato-Oncology Ward, Dr. Soetomo Hospital. E. coli was the mostly found gram negative rods. Gram positive cocci showed a high resistant to penicillin and co-trimoxazole. E. coli, mostly found in rectal swab and urine, has a high sensitivity to amikacin and meropenem, but highly resistant to  ampicillin and ampicillin sulbactam.

AMPICILLIN SULBACTAM RESISTANCE PATTERN AS A FIRST-LINE DRUG IN CHILDREN

Infection often occurs in children with malignant hematology and causes morbidity and mortality. Antibiotics should be given based on the results of culture and antibiotic susceptibility test. Ampicillin Sulbactam is a first-line drug in children with infection. The purpose of this study was to obtain an objective overview of Ampicillin Sulbactam resistance patterns of culture in patients hospitalized in pediatric Hemato-Oncology Ward, Dr Soetomo Hospital, Surabaya. This was a descriptive study. Data on culture and susceptibility test result to Ampicillin Sulbactam were taken from medical records of those patients between September 2012 - February 2013. There were 342 culture examinations in 88 patients (44 girls and 44 boys). Most of the children aged <5 years (58%). Growth of bacterial cultures was obtained in 83 namely Escherichia coli, Burkholderia cepacia, and Klebsiella oxytoca (Gram-negative) and coagulation negative Staphylococcus (CONS), Staphylococcus aureus, and Staphylococcus saprophyticus (Gram-positive) were found in blood culture. Staphylococcus aureus (Gram positive) and E. coli, Klebsiella pneumoniae, and B.cepacia (Gram-negatif) were found in urine. The result of antibiotic susceptibility test culture showed resistance to Ampicillin Sulbactam in E. coli (69%), Burkholderia cepacia (85%), CONS (50%), Staphylococcus aureus (25%), K. pneumoniae (85%), Klebsiella oxytoca (50%), and P. aeroginosa (67%). There was ampicillin sulbactam resistance in children hospitalized in pediatric Hemato-Oncology Ward, Dr Soetomo Hospital, Surabaya against E. coli (69%), Burkholderia cepacia (85%), CONS (50%), Staphylococcus aureus (25%), K.pneumoniae (85%), and Klebsiella oxytoca (50%), P. aeroginosa (67%).