New guidelines for the clinical management of febrile neutropenia and sepsis in pediatric oncology patients

2007 ◽  
Vol 83 (7) ◽  
pp. 54-63 ◽  
Author(s):  
Ana Verena Almeida Mendes ◽  
Roberto Sapolnik ◽  
Núbia Mendonça
Keyword(s):  
Febrile Neutropenia ◽  
Pediatric Oncology ◽  
Clinical Management ◽  
Oncology Patients ◽  
New Guidelines

#31: Risk Factors Associated with Mortality due to Multidrug-Resistant Organisms in Pediatric Oncology Patients with Febrile Neutropenia

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S15-S16
Author(s):  
Miguel A Minero ◽  
Asia Castro ◽  
Martha Avilés-Robles
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Febrile Neutropenia ◽  
Pediatric Oncology ◽  
Pediatric Patients ◽  
Bloodstream Infections ◽  
Oncology Patients ◽  
Factors Associated ◽  
Patients With Cancer ◽  
The Impact

Abstract Background Infectious processes are frequent complications presented in pediatric patients with cancer. Currently, the indiscriminate use of antibiotics induces resistance to available treatments, creating the emergence of multi-drug-resistant organisms (MDROs). Due to the impact in morbidity and mortality secondary to MDRO infection, we aimed to identify risk factors associated with mortality in infections due to MDROs in pediatric patients with cancer. Methods Case–control study nested in a prospective cohort of pediatric oncology patients with febrile neutropenia (FN) at Hospital Infantil de México Federico Gómez (HIMFG) in Mexico City from March 2015 to September 2017. MDRO was defined as acquired non-susceptibility to at least one agent in three or more antimicrobial categories. Patients with FN episodes who died from an infection due to MDROs were defined as cases and patients with FN episodes of an infection due to MDROs who did not die were defined as controls. Mucositis, septic shock, PICU stay, and bacterial prophylaxis (Trimethoprim/Sulfamethoxazole) were compared between groups. Descriptive statistics was performed and Pearson χ 2 or Student’s t-test were used to compare risk factors between groups. Results A total of 929 FN episodes were documented, 44.4% episodes occurred in male patients, mean age was 7.9 years, with the population under 5 years being the most represented (68.2%). The most frequent diagnosis was acute lymphoblastic leukemia in 75% followed by rhabdomyosarcoma in 10.5% and acute myeloid leukemia in 9.6%. Prophylaxis (trimethoprim/sulfamethoxazole) was used in 86%, mucositis was present in 9.2% of episodes. 12.1% had septic shock and 4.7% were admitted to PICU. In 148 FN episodes (15.9%) a microorganism was identified, of these 50 (33.7%) were due to an MDROs. Urinary tract infection was the most frequent site (49%), followed by bloodstream infections (47%). K. pneumoniae was the most frequent MDRO in 22.8%, followed by E. coli in 19.2% and P. aeruginosa in 14%. Septic shock was presented in 26% of MDROs infections. Overall mortality was 1.94% and only 0.86% (8) were secondary to MDROs. Of patients with MDRO isolated mortality was 30% (15/50). Mortality associated with bloodstream infection due to MDROs was 25% compared with other source of MDROs infections (3%) (P = 0.01). Septic shock was present in 40% of patients with death due to MDROs infection (P = 0.001). Conclusions In our population of children with FN episodes who had an isolated microorganism, infection due to MDROs are high (33.7%) and MDROs infection-directed mortality was as high as 30%. Bloodstream infections and septic shock were risk factors associated with mortality due to MDROs.

Spectrum of systemic bacterial infections during febrile neutropenia in pediatric oncology patients in tertiary care pediatric center

2014 ◽  
Vol 51 (4) ◽  
pp. 403 ◽  
Author(s):  
Sirisharani Siddaiahgari ◽  
A Manikyam ◽  
KAnand Kumar ◽  
A Rauthan ◽  
R Ayyar
Keyword(s):  
Febrile Neutropenia ◽  
Pediatric Oncology ◽  
Bacterial Infections ◽  
Tertiary Care ◽  
Oncology Patients ◽  
Pediatric Center

Mannose-binding lectin (MBL) and the risk for febrile neutropenia and infection in pediatric oncology patients with chemotherapy

2010 ◽  
Vol 57 (1) ◽  
pp. 89-96 ◽  
Author(s):  
F.N.J. Frakking ◽  
J. Israëls ◽  
L.C.M. Kremer ◽  
T.W. Kuijpers ◽  
H.N. Caron ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Pediatric Oncology ◽  
Mannose Binding Lectin ◽  
Oncology Patients ◽  
Mannose Binding ◽  
Binding Lectin

Outpatient versus inpatient IV antibiotic management for pediatric oncology patients with low risk febrile neutropenia: A randomised trial

2014 ◽  
Vol 61 (8) ◽  
pp. 1427-1433 ◽  
Author(s):  
Lisa M. Orme ◽  
Franz E. Babl ◽  
Chris Barnes ◽  
Peter Barnett ◽  
Susan Donath ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Pediatric Oncology ◽  
Randomised Trial ◽  
Low Risk ◽  
Oncology Patients ◽  
Antibiotic Management

scholarly journals Limiting Vancomycin Exposure in Pediatric Oncology Patients With Febrile Neutropenia May Be Associated With Decreased Vancomycin-Resistant Enterococcus Incidence

2019 ◽  
Vol 9 (4) ◽  
pp. 428-436 ◽  
Author(s):  
Manjiree V Karandikar ◽  
Carly E Milliren ◽  
Robin Zaboulian ◽  
Poornima Peiris ◽  
Tanvi Sharma ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
High Risk ◽  
Febrile Neutropenia ◽  
Pediatric Oncology ◽  
Antibiotic Use ◽  
Vancomycin Resistant Enterococcus ◽  
Post Intervention ◽  
Oncology Patients ◽  
Vancomycin Resistant ◽  
The Impact

Abstract Background Limited data exists regarding the effects of empiric antibiotic use in pediatric oncology patients with febrile neutropenia (FN) on the development of antibiotic resistance. We evaluated the impact of a change in our empiric FN guideline limiting vancomycin exposure on the development of vancomycin-resistant Enterococcus in pediatric oncology patients. Methods Retrospective, quasi-experimental, single-center study using interrupted timeseries analysis in oncology patients aged ≤18 years with at least 1 admission for FN between 2009 and 2015. Risk strata incorporated diagnosis, chemotherapy phase, Down syndrome, septic shock, and typhlitis. Microbiologic data and inpatient antibiotic use were obtained by chart review. Segmented Poisson regression was used to compare VRE incidence and antibiotic days of therapy (DOT) before and after the intervention. Results We identified 285 patients with 697 FN episodes pre-intervention and 309 patients with 691 FN episodes postintervention. The proportion of high-risk episodes was similar in both periods (49% vs 48%). Empiric vancomycin DOT/1000 FN days decreased from 315 pre-intervention to 164 post-intervention (P < .01) in high-risk episodes and from 199 to 115 in standard risk episodes (P < .01). Incidence of VRE/1000 patient-days decreased significantly from 2.53 pre-intervention to 0.90 post-intervention (incidence rate ratio, 0.14; 95% confidence interval, 0.04–0.47; P = .002). Conclusions A FN guideline limiting empiric vancomycin exposure was associated with a decreased incidence of VRE among pediatric oncology patients. Antimicrobial stewardship interventions are feasible in immunocompromised patients and can impact antibiotic resistance.

scholarly journals The diagnostic value of CRP, IL-8, PCT, and sTREM-1 in the detection of bacterial infections in pediatric oncology patients with febrile neutropenia

2010 ◽  
Vol 19 (10) ◽  
pp. 1593-1600 ◽  
Author(s):  
Karin G. E. Miedema ◽  
Eveline S. J. M. de Bont ◽  
Rob F. M. Oude Elferink ◽  
Michel J. van Vliet ◽  
Claudi S. M. Oude Nijhuis ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Pediatric Oncology ◽  
Bacterial Infections ◽  
Diagnostic Value ◽  
Oncology Patients

scholarly journals Clinical Characteristics and Predictive Factors of Invasive Fungal Disease in Pediatric Oncology Patients with Febrile Neutropenia in a Country with Limited Resources

2021 ◽  
Vol Volume 12 ◽  
pp. 335-345
Author(s):  
Chalinee Monsereenusorn ◽  
Thitiyaporn Sricharoen ◽  
Piya Rujkijyanont ◽  
Detchvijitr Suwanpakdee ◽  
Apichat Photia ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Predictive Factors ◽  
Pediatric Oncology ◽  
Clinical Characteristics ◽  
Invasive Fungal Disease ◽  
Fungal Disease ◽  
Limited Resources ◽  
Oncology Patients

scholarly journals Meropenem Versus Piperacillin-Tazobactam as Empiric Therapy for Febrile Neutropenia in Pediatric Oncology Patients

2014 ◽  
Vol 15 (11) ◽  
pp. 4549-4553 ◽  
Author(s):  
Gulay Sezgin ◽  
Can Acipayam ◽  
Ayse Ozkan ◽  
Ibrahim Bayram ◽  
Atila Tanyeli
Keyword(s):  
Febrile Neutropenia ◽  
Pediatric Oncology ◽  
Empiric Therapy ◽  
Oncology Patients
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