Display Settings:

Format

Send to:

Choose Destination
Pediatr Blood Cancer. 2010 Jan;54(1):83-7. doi: 10.1002/pbc.22264.

Bacteremia in febrile nonneutropenic pediatric oncology patients.

Author information

  • 1Department of Pediatric Hematology Oncology, Hasbro Children's Hospital, Providence, RI 02903, USA. michael_kelly@brown.edu

Abstract

BACKGROUND:

We sought to determine the risk of bacteremia in a cohort of outpatient febrile nonneutropenic pediatric oncology patients and to assess clinical characteristics that may influence decisions regarding empiric antibiotic therapy.

PROCEDURE:

A single institution retrospective cohort study was performed of outpatient pediatric oncology patients presenting with fever, a central venous catheter, and an absolute neutrophil count (ANC) of >/=500/microl over a 6-year period. We also collected data regarding the presence of clinically evident infections, antibiotics prescribed, and the sensitivity of bacteria to specific antibiotics.

RESULTS:

There were 29 cases of bacteremia in 459 (6.3%) febrile outpatient visits by 167 patients. Bacteremia was documented in 4.4% of patients with ports and in 16.2% of patients with external catheters. Patients with external catheters had a relative risk of bacteremia of 3.7 (95% CI: 1.8-7.4) times the risk of those with internal catheters (P < 0.0001). A documented source for fever on exam was noted in 21% of patients but in none of the patients with bacteremia (P = 0.004). Empiric treatment with ceftriaxone was administered to 92% of the patients. Of the high-risk bacteremic infections (Gram-negative organisms, Streptococcus pneumoniae, viridans group streptococcus, and Staphylococcus aureus) 94% had at least an intermediate sensitivity to ceftriaxone.

CONCLUSIONS:

Bacteremia is an important issue in febrile nonneutropenic pediatric oncology patients occurring in 6% of the patient visits in this study. The overall sensitivity of high-risk bacteremia to ceftriaxone provides justification for its empiric use in outpatient febrile nonneutropenic pediatric oncology patients.

Copyright 2009 Wiley-Liss, Inc.

PMID:
19774640
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for John Wiley & Sons, Inc.
    Loading ...
    Write to the Help Desk