Comparison of isolates and antibiotic sensitivity pattern in pediatric and adult cancer patients; is it different.

BACKGROUND: Infection is a common cause of mortality and morbidity in cancer patients. Organisms are becoming resistant to antibiotics; age appears to be one of the factors responsible. We analyzed common organisms and their antibiotic sensitivity pattern in the correlation with age. METHODS: This is a single institutional, retrospective analysis of all culture positive adult and pediatric cancer patients from January 2007 to December 2007. For statistical analysis, Chi‑square test for trend was used and P values were obtained. Of 1251 isolates, 262 were from children <12 years of age and 989 were from adolescents and adults (>12 years of age). Gram‑negative organisms were predominant (64.95) while Gram‑positive constituted 35.09% of isolates. RESULTS: The most common source in all age groups was peripheral‑blood, accounting to 47.8% of all samples. The most common organisms in adults were Pseudomonas aeruginosa (15.3%) while in children it was coagulase negative Staphylococcus aureus (19.8%). Antibiotic sensitivity was different in both groups. In pediatric group higher sensitivity was seen for Cefoparazone‑sulbactum, Cefipime, Amikacin, and Tobramycin. No resistance was found for Linezolid. CONCLUSIONS: The isolates in both children and adults were predominantly Gram‑negative though children had proportionately higher Gram‑positive organisms. High‑dose cytarabine use, cotrimoxazole prophylaxis, and frequent use of central lines in children especially in hematological malignancies could explain this observation. Children harbor less antibiotic resistance than adults; Uncontrolled, cumulative exposure to antibiotics in our community with increasing age, age‑related immune factors and variable bacterial flora in different wards might explain the higher antibiotic resistance in adults. Thus age is an important factor to be considered while deciding empirical antibiotic therapy.

Study of leprosy among slum dwellers in Pune. Part II--Disabilities.

While conducting a leprosy survey in an urban slum in Pune 45 cases of leprosy were detected in a population of 4915 and only 7 of these cases had some disability. Disability rate in the leprosy cases was 15.56 percent, and maximum number had Grade 2 disability of hands or feet. Disability was higher in the higher age groups, males, Hindus, widower/widows, unemployed and lower socio-economic classes. Majority of the cases had a very low Disability Index DI (2) between 0.10 to 0.69 which is heartening and proves the successful implementation of the National Leprosy Eradication Programme.

Study of leprosy among slum dwellers in Pune. Part-I. Prevalence.

While conducting a point prevalence total population survey in Ghorpuri slum in Pune, the overall prevalence or leprosy was 9.16 per thousand. The prevalence rate varied in different bastis with Madari basti having a very high prevalence rate of 17.31 per thousand and showing clustering. Prevalence was highest in age group 31-40 years, females, Muslims, Widower/widow, skilled workers, illiterates and primary school educated and the lower socio-economic groups. Joint families had the highest prevalence of leprosy (20.83/1,000) and also higher prevalence was seen in families with more than 7 members.