[Bacteraemia risk criteria in the paediatric febrile neutropenic cancer patient].
BACKGROUND
Cancer patients with febrile neutropenia are not a homogeneous group with respect to risk of bacterial infections. Some authors have proposed that febrile cancer patients with low risk factors of bacteraemia could be managed at home with domiciliary antibiotic treatment. The objectives are: to determine the incidence of bacteraemia in our cancer patients who have febrile neutropenia; and to identify the low-risk factors so that the patients can be managed at home using domiciliary antibiotic treatment.


METHODS
Clinical review of paediatric haemato-oncology disease admitted to our hospital in 2002 suffering from febrile neutropenia.


RESULTS
We describe a total of 62 episodes of febrile neutropenia in 30 patients; 24 episodes in haematology patients and 38 episodes in oncology patients. High-risk criteria are age <1 year, poor bone-marrow recovery, chemotherapy within 10 days of the episode, rapid fast neutropenia, leukaemia in relapse, uncontrolled solid cancer, and cardiac or nephrology disease. Based on the number of risk-factors, patients with two or less risk-factors have an incidence of bacteraemia of 6.7% (1/16) and patients with three or more risk factors have an incidence of bacteraemia of 32.6% (15/46); p<0.05.


CONCLUSIONS
Incidence of bacteraemia is similar to the reviewed literature; probability of bacteraemia increases with the number of individual risk factors, and patients with low risk of bacteraemia could be managed on an outpatient basis using domiciliary antibiotic treatment.
Gala Peralta
Sandra
S
Sección de Urgencias, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, España. sgala@hsjbcn.org
Cardesa Salzman
Teresa
T
García García
Juan José
JJ
Estella Aguado
Jesús
J
Gené Giralt
Amadeu
A
Luaces Cubells
Carles
C
D000293:Adolescent; D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000150:complications*; D012307:Risk Factors