Abstract

Background: Patients with malignancies are prone to bloodstream infections (BSI) making them at an increased risk of morbidity and mortality. Blood culture often takes a long time delaying the initiation of antibiotic therapy. Appropriate treatment requires availability of the local data to guide empirical treatment. In view of this, we conducted this study to determine the magnitude of BSI, patterns of the bacteria and factors associated with BSI among children with malignancies.

Methodology: A hospital based cross sectional study was conducted from January to May 2024 among 182 children aged 0 to 18 years with malignancies attending and admitted at Bugando Medical Centre. Physical examination, complete blood count, blood culture and drug susceptibility testing were done. Data analysis was performed using STATA version 15.

Results: More than half 53.8% (98/182) of enrolled children were male with median age of 6 [IQR 3-12] years. The prevalence of BSI was found to be 6.0% (11/182, 95% CI: 2.5-9.4) in which more than half 54.5% (6/11) was due to Gram-positive bacteria. Predominant Gram-positive bacteria isolates was Staphylococcus aureus 50.0% (3/6) while predominant Gram-negative bacteria was Acinetobacter spp. 40.0% (2/5). Gram-positive bacteria were uniformly susceptible to vancomycin and linezolid while Gram-negative bacteria were all susceptible to meropenem, amikacin and ceftriaxone sulbactam. Neutropenia (OR-12.2[95% CI:1.0-144.3], P=0.047) was significantly associated with BSI.

Conclusion: Gram-positive bacteria were commonly found to cause BSI which was significantly associated with neutropenia. There is a need for routine blood culture among cancer patients to provide more data to guide appropriate antibiotic treatment in this vulnerable population