|Title:||Bacteremia in hematological and oncological children with febrile neutropenia: Experience in a tertiary medical center in Taiwan||Authors:||Lai H.-P.
|Issue Date:||2003||Journal Volume:||36||Journal Issue:||3||Start page/Pages:||197-202||Source:||Journal of Microbiology, Immunology and Infection||Abstract:||
A retrospective study of bacteremia in children with febrile neutropenia admitted to a medical center in Taiwan from January 1999 to December 1999 was performed. There were 190 episodes of febrile neutropenia during this period and 46 pathogens were isolated from blood specimens in 38 bacteremic episodes (7 mixed infections). Pseudomonas aeruginosa (17.4%), Staphylococcus aureus (10.9%), Klebsiella pneumoniae (10.9%), and Enterobacter cloacae (10.9%) were the most common isolates. Three of the 5 isolates of S. aureus were resistant to methicillin. Twenty-three episodes of bacteremia (four mixed infections) were associated with recent antibiotic use. Of the 23 bacteremic episodes with recent antibiotic use, P. aeruginosa (20%), methicillin-resistant S. aureus (10%), K. pneumoniae (10%), Escherichia coli (10%), and E. cloacae (10%) were isolated most often. Relapsed leukemia (odds ratio 3, 95% confidence interval 1.4-6.5) and recent antibiotic therapy (odds ratio 3.4, 95% confidence interval 1.7-7.7) were the independent risk factors of bacteremia. There were 9 mortality cases in patients with bacteremia, including 4 cases with mixed infections, and 5 cases with P. aeruginosa, E. coli, Klebsiella oxytoca, S. aureus, and Streptococcus mitis, respectively. Broad-spectrum antibiotics were necessary in febrile neutropenic children because of the high percentage of mixed infection.
|ISSN:||0253-2662||SDG/Keyword:||amikacin; amphotericin B; antibiotic agent; ceftazidime; cotrimoxazole; gentamicin; granulocyte colony stimulating factor; granulocyte macrophage colony stimulating factor; meticillin; piperacillin; steroid; timentin; adolescent; adult; antibiotic therapy; article; bacteremia; bacterial infection; bacterium isolate; cancer recurrence; child; confidence interval; drug use; Enterobacter cloacae; febrile neutropenia; female; hematologic malignancy; human; infant; Klebsiella oxytoca; Klebsiella pneumoniae; major clinical study; male; methicillin resistant Staphylococcus aureus; mixed infection; mortality; oncology; Pseudomonas aeruginosa; retrospective study; risk factor; Staphylococcus aureus; steroid therapy; Streptococcus mitis; Taiwan; Academic Medical Centers; Adolescent; Adult; Anti-Bacterial Agents; Bacteremia; Child; Child, Preschool; Female; Fever; Hematologic Neoplasms; Humans; Infant; Male; Neoplasms; Neutropenia; Retrospective Studies; Risk Factors; Taiwan
|Appears in Collections:||醫學系|
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