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Background Acute lymphoblastic leukemia (ALL) is the most common cancer diagnosed in children worldwide. This study was conducted to find out the trends in the bacteriological spectrum and antibiotic susceptibility on blood culture in newly diagnosed children with acute lymphoblastic leukemia during the induction phase at a pediatric oncology unit in South Punjab, Pakistan. Methodology This cross-sectional study was conducted from January 1, 2020, to June 30, 2021. A total of 263 newly diagnosed ALL cases of both genders aged up to 16 years were included. Adopting full aseptic measures, the blood samples of all children were sent for culture and sensitivity testing to the institutional laboratory immediately after collection on the eighth day of the induction phase in all children. Bacterial isolates and their sensitivity/resistance patterns were noted. Results Out of 263 children with ALL, 172 (65.4%) were males. Overall, the mean age was 7.4±3.4 years (ranging between 1 and 16 years). B-cell type was the commonest type noted in 204 (77.6%) children. Out of a total of 52 cases with positive blood culture findings for bacterial isolates, there were 28 (53.8%) cases with gram-negative bacterial isolates, while 24 (46.2%) were gram-positive bacterial isolates. Escherichia coli (E. coli) was the commonest type of gram-negative bacteria noted among 18/28 (64.3%) cases, while Staphylococcus aureus (S. aureus) was the most frequent gram-positive bacterial isolates in 13/24 (54.2%). We found meropenem, linezolid, clindamycin, piperacillin, tazobactam, and amikacin to have the highest antimicrobial sensitivities, while commonly adopted antibiotics such as ciprofloxacin, cefotaxime, cefoperazone, amoxiclav, and ampicillin were found to have high resistance rates. Conclusion Gram-negative bacterial isolates formed the majority of the positive blood culture cases. Escherichia coli, Staphylococcus aureus, and Klebsiella pneumonia (K. pneumonia) were the most common types of bacterial isolates. Routinely used antibiotics such as ciprofloxacin, cefotaxime, cefoperazone, and ampicillin were found to have high rates of resistance.
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BACKGROUND & OBJECTIVES: Vincristine has been used as chemotherapeutic agent for many decades. It implements its function by inhibiting the duplication of tumor cells by destroying the DNA. However, like all other drugs, its administration is not without any side effects. The most important of these are being the neurotoxic side effects. This study evaluated the degree of neurotoxicity induced by vincristine in children who underwent chemotherapy for acute lymphoblastic leukemia and Wilms tumor. METHODS: A quasi experimental study was conducted at Children Hospital & the Institute of Child Health, Multan from January 2020 to October 2020 after taking informed written consent. In this study, 150 children of age group 1 - 12 years with pathological confirmation of acute lymphoblastic leukemia and Wilms tumor who had undergone a chemotherapy protocol including at least four consecutive weekly Vincristine injections were included, using probability consecutive sampling technique. Neurological examination was conducted on them on weekly basis. RESULTS: There were 150 patients,90(60%) males and 60(40%) females with mean age of (5.5±2.2). Diminished patellar and Achilles tendon reflexes were seen in 48% and 52% of patients. Muscular weakness was seen in 60% of patients. Other side effects like hoarseness, jaw pain, constipation and petosis were observed in 10%, 8%,40% and 10% of patients respectively. Frequency of side effects was equally observed in both sexes and it was more among age group older than five years (p= 0.01). CONCLUSION: Vincristine regimen produces some neurotoxic side effects in children but nearly all of these are of mild to moderate in nature.