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.
Department of Pediatrics, God's Help Hospital, Taipei, Taiwan, ROC.
Hsin-Pao
HP
Lai
Po-Ren
PR
Hsueh
Yee-Chun
YC
Chen
Ping-Ing
PI
Lee
Chun-Yi
CY
Lu
Meng-Yao
MY
Lu
Wen-Chuan
WC
Lin
Yu-Chia
YC
Hsieh
Chin-Yun
CY
Lee
Kai-Hsin
KH
Lin
Li-Min
LM
Huang
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