Bacteremia in hematological and oncological children with febrile neutropenia: experience in a tertiary medical center in Taiwan.
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.
Lai
Hsin-Pao
HP
Department of Pediatrics, God's Help Hospital, Taipei, Taiwan, ROC.
Hsueh
Po-Ren
PR
Chen
Yee-Chun
YC
Lee
Ping-Ing
PI
Lu
Chun-Yi
CY
Lu
Meng-Yao
MY
Lin
Wen-Chuan
WC
Hsieh
Yu-Chia
YC
Lee
Chin-Yun
CY
Lin
Kai-Hsin
KH
Huang
Li-Min
LM
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000150:complications; D019337:Hematologic Neoplasms / Q000150:complications; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan
D000900:Anti-Bacterial Agents