https://scholars.lib.ntu.edu.tw/handle/123456789/566610
標題: | Invasive fungal infection in children with persistent febrile neutropenia | 作者: | Lai H.-P. YEE-CHUN CHEN LUAN-YIN CHANG CHUN-YI LU CHIN-YUN LEE KAI-HSIN LIN LI-MIN HUANG |
公開日期: | 2005 | 卷: | 104 | 期: | 3 | 起(迄)頁: | 174-179 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background and Purpose: Children with persistent febrile neutropenia (fever > 96 hours) refractory to antibacterial therapy carry a high risk of invasive fungal infection (IFI). However, epidemiologic data in such patient populations is lacking in Taiwan. Methods: A retrospective study was conducted to identify risk factors and outcome of IFI in children with persistent febrile neutropenia (> 96 hours) hospitalized at National Taiwan University Hospital from January 1, 1999 through December 31, 1999. They were categorized into proven, probable, possible, or no IFI according to host, microbiologic and clinical criteria. Results: A total of 29 episodes (35,4%) of IFI occurred in 82 episodes of persistent febrile neutropenia and included 1 proven, 12 probable and 16 possible cases. Pneumonia was most common (69.0%), followed by disseminated infection (17.2%), paranasal sinusitis (6.9%), and hepatosplenic abscess (6.9%). Multivariate analysis revealed 4 risk factors independently associated with IFI prolonged neutropene. (> 30 days; odds ratio [OR], 10.4; 95% confidence interval [CI], 1.8-60.5), prolonged steroid therapy (OR 2.0, 95% CI 1.0-10.8), allogeneic bone marrow transplantation (OR 5.3, 95% CI 1.0-28.0), and relapsed malignancy (OR 3.5, 95% CI 1.1-11.1). Patients with IFI carried higher in-hospital mortality than those without (51:7% vs 3.8%, p < 0.001). Among those with IFI, delayed antifungal therapy (persistent fever > 7 days) was associated with higher mortality rate than earlier treatment (73.3% vs 28.6%, p & 0.024) and was an independent adverse prognostic factor. Conclusion: IFI was common in patients with persistent febrile neutropenia and delayed antifungal therapy was an independent adverse prognostic factor. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-19144362729&partnerID=40&md5=9680a67db6609d0db84db9214f1fed2e https://scholars.lib.ntu.edu.tw/handle/123456789/566610 |
ISSN: | 0929-6646 | SDG/關鍵字: | amikacin; amphotericin B deoxycholate; antifungal agent; ceftazidime; cotrimoxazole; gentamicin; piperacillin; timentin; adolescent; adult; article; child; clinical feature; controlled study; disease association; febrile neutropenia; female; hospitalization; human; infant; infection risk; liver abscess; major clinical study; male; mycosis; paranasal sinusitis; pneumonia; prognosis; retrospective study; spleen abscess; treatment outcome; university hospital; chi square distribution; fever; mycosis; neoplasm; neutropenia; nonparametric test; preschool child; risk factor; statistical model; Adolescent; Adult; Chi-Square Distribution; Child; Child, Preschool; Female; Fever; Humans; Infant; Logistic Models; Male; Mycoses; Neoplasms; Neutropenia; Retrospective Studies; Risk Factors; Statistics, Nonparametric; Treatment Outcome |
顯示於: | 醫學系 |
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