ANTIBIOTHERAPY IN PEDIATRIC ONCOLOGICAL PATIENTS WITH POSITIVE BACTERIAL INFECTION POST-TREATMENT

Paediatric oncology patients are particularly vulnerable to severe infections due to immunosuppression induced by chemotherapy and hematologic malignancies.This retrospective study analysed 150 infectious episodes in 94 patients admitted to a tertiary paediatric oncology centre in Bucharest between 2018 and 2022.Fifty episodes with microbiologically confirmed sepsis were included for detailed evaluation.The majority of infections were caused by Gram-positive cocci, predominantly Staphylococcus aureus and Staphylococcus epidermidis, although Gram-negative organisms such as Acinetobacter baumannii and Escherichia coli were also detected.Antibiotic susceptibility profiling revealed complete sensitivity to linezolid, vancomycin, and meropenem, while high resistance was observed against ampicillin, oxacillin, and amoxicillin-clavulanate.Approximately 60% of patients responded to monotherapy, while combination therapy was employed in 40% of cases.Tazobactam, ceftazidime, and meropenem were the most frequently used first-line antibiotics, whereas amikacin and vancomycin were favoured in second-line regimens.These findings underscore the necessity of ongoing antimicrobial surveillance and tailored empirical therapy in paediatric oncology patients.The study supports the role of cumulative antibiograms and local resistance data in informing antimicrobial stewardship strategies and improving infection-related outcomes in immunocompromised children. RezumatPacienii pediatrici oncologici sunt deosebit de vulnerabili la infecii severe, ca urmare a imunodepresiei induse de chimioterapie i a afeciunilor maligne hematologice.Acest studiu retrospectiv a analizat 150 de episoade infecioase la 94 de pacieni internai ntr-un centru oncologic pediatric teriar din Bucureti, n perioada 2018-2022.Cincizeci de episoade cu sepsis confirmat microbiologic au fost incluse pentru evaluare detaliat.Majoritatea infeciilor au fost cauzate de coci Gram pozitivi, n special de speciile Staphylococcus aureus i Staphylococcus epidermidis, ns au fost identificate i bacterii Gram negative precum Acinetobacter baumannii i Escherichia coli.Profilul de sensibilitate la antibiotice a evideniat o susceptibilitate complet la linezolid, vancomicin i meropenem, n timp ce s-a observat o rezisten ridicat la ampicilin, oxacilin i amoxicilin-clavulanat.Aproximativ 60% dintre pacieni au rspuns la monoterapie, iar n 40% dintre cazuri s-au utilizat scheme de tratament combinate.Tazobactamul, ceftazidima i meropenemul au fost cele mai frecvent utilizate antibiotice de prim linie, n timp ce amikacina i vancomicina au fost preferate n tratamentele de linia a doua.Aceste rezultate evideniaz necesitatea supravegherii continue a rezistenei antimicrobiene i a individualizrii tratamentului empiric la pacienii pediatrici oncologici.Studiul susine importana antibiogramelor cumulative i a datelor locale privind rezistena bacterian n optimizarea strategiilor de stewardship antimicrobian i n mbuntirea prognosticului infeciilor la copiii imunocompromii.