{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:04:08Z","timestamp":1791821048516,"version":"4.3.4"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In children receiving therapy for acute myeloid leukemia (AML), gram-negative bacteremia is associated with significant morbidity and mortality, especially in the presence of multi-drug resistant [MDR] organisms. objectives: The purpose of this study was to determine the prevalence and antibiotic susceptibility patterns of gram negativebloodstream infections [GNBSI]] during the period of induction chemotherapy [IC] and the associated morbidity and mortality in a large pediatric oncology hospital in a low- middle-income country (LMIC). patients and methods: This is a retrospective analysis of consecutive newly diagnosed patients with acute myeloid leukemia (AML) admitted for induction chemotherapy (IC) from January 2015 to December 2017 at the Children\u2019s Cancer Hospital Egypt 57357.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 90[27.4%] children with at least one GNBSI during induction, 72\/90[80%] of whom had at least one MDR GNBSI. 124 GNBSI episodes were identified among the ninety children:\n                      <jats:italic>E.coli<\/jats:italic>\n                      54.8%,\n                      <jats:italic>K.pneumoniae<\/jats:italic>\n                      16.9%,\n                      <jats:italic>A.baumannii<\/jats:italic>\n                      6.5%,\n                      <jats:italic>E.cloacae<\/jats:italic>\n                      4.8%, and\n                      <jats:italic>P.aeruginosa<\/jats:italic>\n                      4.0%. Thirty-day cumulative infection-related mortality was 27.8% [18.9-37.3%]. Associated morbidity included typhlitis [29\/90 (32.2%)], sepsis-related central venous catheter [CVC] removal [12\/90 (13.3%)], and admission to intensive care unit [38\/90(42%)].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study highlights the prevalence of gram-negative bacteria among febrile neutropenic children with AML and the high incidence of antibiotic resistance in our hospital. There is a need for keen surveillance globally of the epidemiology of multi-drug resistant gram-negative organisms and thoughtful studies into antibiotic stewardship to reduce the growing threat of MDR GN infections and the associated morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2025.1540831","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T04:37:05Z","timestamp":1776832625000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Gram-negative blood-stream infections and emerging antimicrobial resistance in children with acute myeloid leukemia during induction chemotherapy at Children\u2019s Cancer Hospital Egypt 57357"],"prefix":"10.3389","volume":"15","author":[{"given":"Grace","family":"Mbatia","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology Aga Khan University Hospital","place":["Nairobi, 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Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omneya","family":"Hassanain","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Children\u2019s Cancer Hospital Egypt 57357","place":["Cairo, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lobna","family":"Shalaby","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department at Children\u2019s Cancer Hospital Egypt 57357","place":["Cairo, Egypt"]},{"name":"Pediatric Oncology Department at National Cancer Institute, Cairo University","place":["Cairo, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Elhaddad","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department at Children\u2019s Cancer Hospital Egypt 57357","place":["Cairo, Egypt"]},{"name":"Pediatric Oncology Department at National Cancer Institute, Cairo University","place":["Cairo, 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