[Bloodstream infections in children with cancer and high risk fever and neutropenia episodes in six hospitals of Santiago, Chile between 2004 and 2009].
BACKGROUND
To determine the etiology of invasive bacterial infection in high risk febrile neutropenia (HRFN) episodes in children with cancer is essential because of the favorable impact on mortality of the early empiric antibiotic treatment.


OBJECTIVE
To determine the etiology of bacteremia in pediatric patients with cancer and HRFN in the National Child Program of Antineoplastic Drugs during the 2004-2009 period, and compare these agents and their antimicrobial susceptibility with the period 1994-1998 described in a previous study.


METHODS
The causative agents of bacteremia were prospectively recorded in patients less than 18 years of age receiving chemotherapy for cancer with HRFN and positive blood cultures admitted to one of the six hospitals from the Child Program of Antineoplastic Drugs network during the period 2004-2009.


RESULTS
839 episodes of HRFN were identified; 181 blood cultures were positive in the following proportion: gram positive cocci (56%), gram negative bacilli (42%) and yeast (2%).The most common etiologic agents were Staphylococcus coagulase negative (25%), Escherichia. coli (20%), group viridans Streptococcus (14%), Staphylococcus aureus (13%) and Pseudomonas aeruginosa (9%). Comparing the two periods, the relative frequency of Streptococcus spp increased from 4 to 17%, coagulase negative Staphylococcus decreased from 44 to 25%, showing an increase in their resistance to oxacillin from 55% to 77%.


CONCLUSIONS
We describe the main etiological agents from HRFN episodes in children with cancer in a 5 years period. This information could help for a better approach in the empirical antimicrobial therapy in this population.
Programa de formación de especialistas en Infectología Pediátrica, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Yanahara
Y
Solís
Ana M
AM
Álvarez
David
D
Fuentes
Daniela
D
de la Barra
Carmen L
CL
Avilés
Ana
A
Becker
Carmen
C
Salgado
Pamela
P
Silva
Santiago
S
Topelberg
Juan
J
Tordecilla
Mónica
M
Varas
Milena
M
Villarroel
Tamara
T
Viviani
Marcela
M
Zubieta
Sócrates
S
Aedo
María E
ME
Santolaya
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000382:microbiology*; D002648:Child; D002677:Chile; D005260:Female; D005334:Fever / Q000382:microbiology*; D006090:Gram-Negative Bacteria / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009369:Neoplasms / Q000382:microbiology*; D009503:Neutropenia / Q000382:microbiology*; D011446:Prospective Studies
D000900:Anti-Bacterial Agents