The Risk of Serious Bacterial Infection in Neutropenic Immunocompetent Febrile Children.
Only few reports have looked into the risk of invasive bacterial infection in children with neutropenia that is not malignancy related. The objective of the current study was to determine the clinical significance of neutropenia as a predictor of serious bacterial infection (SBI) in immunocompetent children. We conducted a retrospective case-control study including children 3 months to 18 years of age with fever ≥ 38°C hospitalized or presenting to the emergency department. Patients who had neutropenia ≤ 1000 ANC/μL and had a blood culture taken were matched for age with the consecutive febrile patients for whom a blood culture was taken. The main outcome was the rate of SBI. SBIs were more prevalent among the control group than in the group of children with neutropenia, 19/71 and 6/71, respectively (P = 0.0005). More children were treated with antibiotics among the control group than in the group of children with neutropenia, 39/71 and 20/71, respectively (P < 0.0001). Acute-phase reactants including CRP and platelets were higher in the control group. We concluded that immunocompetent patients with fever and moderate neutropenia do not carry a higher risk for SBIs compared with patients with fever who do not have neutropenia.
Departments of *Pediatrics §Microbiology †Pediatric Emergency Unit, Assaf Harofeh Medical Center, Zerifin ‡Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Assaf A
AA
Barg
Eran
E
Kozer
Yair
Y
Mordish
Tsilia
T
Lazarovitch
Iris
I
Kventsel
Michael
M
Goldman
D000209:Acute-Phase Proteins / Q000032:analysis; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005500:Follow-Up Studies; D006801:Humans; D007121:Immunocompetence; D007223:Infant; D008297:Male; D009367:Neoplasm Staging; D009503:Neutropenia / Q000150:complications* / Q000276:immunology; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies
D000209:Acute-Phase Proteins; D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein