Septicaemia in febrile neutropenic children with cancer in Saudi Arabia.
The pattern of sepsis among 56 children admitted for various forms of cancer to the King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia during a 6-year period, was retrospectively reviewed. A total of 148 febrile neutropenic episodes occurred and 55 of these, in 40 patients, were associated with positive blood cultures. The isolates were Gram-positive bacteria in 54% of instances, Gram-negative bacteria in 39.4% and Candida in 6.6% and polymicrobial sepsis occurred in five patients. Profound neutropenia (neutrophil counts less than 0.1 x 10(9) l-1) significantly predisposed to Gram-negative sepsis (P less than 0.02), which was responsible for about one-third of deaths in this series. Central venous catheters were present prior to 49% of the septicaemic episodes, but were not significantly associated with either increased Gram-negative or Gram-positive bacterial sepsis. However, all four cases of candidaemia occurred in patients with a central venous catheter in situ, and it is recommended that early empirical treatment for candida be considered in all febrile neutropenic cancer patients with central venous catheters.
Department of Pediatrics, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
I M
IM
al-Fawaz
A M
AM
Kambal
A A
AA
al-Rabeeah
S A
SA
al-Rasheed
Y A
YA
al-Eissa
J B
JB
Familusi
D002405:Catheterization, Central Venous / Q000009:adverse effects; D015984:Causality; D002648:Child; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D005260:Female; D005334:Fever / Q000209:etiology*; D006785:Hospitals, University; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000097:blood / Q000150:complications*; D009504:Neutrophils / Q000737:chemistry; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology