OBJECTIVE: Children with leukemia are highly susceptible to healthcare-associated infections (HAIs) due to immunosuppression, mucosal barrier injury, and frequent hospital exposures. Nasal colonization may predict invasive infections, but evidence from low- and middle-income countries (LMIC) is limited. To describe patterns of nasal colonization and bloodstream isolates in pediatric leukemia with HAIs. MATERIALS AND METHODS: This descriptive study was conducted in the pediatric hemato-oncology ward of Dr. Kariadi General Hospital, Indonesia, from May 2024 to May 2025. Children aged 1 month-18 years with leukemia and developed HAIs were included. Blood and nasal swab cultures were obtained, while microbiological examinations were performed. Data were summarized descriptively to characterize microbiological patterns. RESULTS: Among 22 children, nasal colonization with Gram-positive bacteria was nearly universal (90.9%), while bloodstream infections were mainly Gram-negative (22.7%), including Klebsiella pneumoniae, Escherichia coli, Pantoea sp., and Serratia marcescens. Based on observations, no patient harbored identical organisms in both sites. CONCLUSION: This study described distinct microbiological patterns between nasal colonization and bloodstream isolates in pediatric leukemia with HAIs in LMIC settings. Gram-negative bacteria remained the main invasive threat. The results support the need for strengthened infection surveillance, empiric gram-negative coverage, and integrated nutritional support in pediatric oncology care.
Anantyo et al. (Mon,) studied this question.