Korean J Pediatr Infect Dis.  2010 Jun;17(1):36-48.

Bloodstream Infections in Children with Cancer between 2005 and 2008 in a Single Center

Affiliations
  • 1Department of Pediatrics, Hanyang University School of Medicine, Seoul, Korea. sungheeo@hanyang.ac.kr

Abstract

PURPOSE
In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients.
METHODS
All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared.
RESULTS
Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P=0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P=0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P=0.001).
CONCLUSION
The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.

Keyword

Fever; Neutropenia; Neoplasms; Bacteremia; Catheters; Indwelling

MeSH Terms

Anti-Bacterial Agents
Bacteremia
Catheters
Central Venous Catheters
Child
Fetal Blood
Fever
Fungi
Gram-Negative Bacteria
Gram-Positive Bacteria
Humans
Neutropenia
Pediatrics
Transplants
Anti-Bacterial Agents
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