Risk assessment and microbiological profile of infections in paediatric cancer patients with febrile neutropenia.

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Abstract

Febrile neutropenia is a common and potentially fatal problem encountered in cancer patients undergoing chemotherapy. We carried out an observational study to evaluate the possible risk factors of developing fever amongst neutropenic children with an underlying malignancy. We also looked at the microbiological profile of causative pathogens in patients with febrile neutropenia. During a study period of 1 year, a total of 90 neutropenic episodes were recorded amongst 57 patients who were on treatment and follow-up during the study period. Multivariate analysis showed that factors such as chemotherapy status, underlying disease, existing central venous catheters, presenting white blood cell counts at chemotherapy, use of steroid therapy or hospitalisation at the onset of neutropenia, were not significant risk factors for developing fever during neutropenic episodes. Although the presence of a central venous catheter was associated with a higher risk of developing fever, it did not reach statistical significance (p=0.11). Of the 90 neutropenic episodes, 59 (65.6%) developed fever and 25 of these had positive blood cultures. The causative organisms include gram-negative bacteria (64%), gram positive bacteria (16%) and fungus (20%). Of the gram-negative organisms, Klebsiella spp. predominated (28%) with the extended spectrum beta-lactamase producing strain forming the majority (16%). Amongst those with fungaemia, Candida spp. and Candida tropicalis formed the majority (8% each) of the isolates.

Original languageEnglish
Pages (from-to)83-89
Number of pages7
JournalThe Malaysian journal of pathology
Volume24
Issue number2
Publication statusPublished - 2002

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Febrile Neutropenia
Fever
Pediatrics
Central Venous Catheters
Infection
Drug Therapy
Neoplasms
Fungemia
Candida tropicalis
Klebsiella
Gram-Positive Bacteria
beta-Lactamases
Neutropenia
Gram-Negative Bacteria
Leukocyte Count
Candida
Observational Studies
Hospitalization
Fungi
Multivariate Analysis

Cite this

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title = "Risk assessment and microbiological profile of infections in paediatric cancer patients with febrile neutropenia.",
abstract = "Febrile neutropenia is a common and potentially fatal problem encountered in cancer patients undergoing chemotherapy. We carried out an observational study to evaluate the possible risk factors of developing fever amongst neutropenic children with an underlying malignancy. We also looked at the microbiological profile of causative pathogens in patients with febrile neutropenia. During a study period of 1 year, a total of 90 neutropenic episodes were recorded amongst 57 patients who were on treatment and follow-up during the study period. Multivariate analysis showed that factors such as chemotherapy status, underlying disease, existing central venous catheters, presenting white blood cell counts at chemotherapy, use of steroid therapy or hospitalisation at the onset of neutropenia, were not significant risk factors for developing fever during neutropenic episodes. Although the presence of a central venous catheter was associated with a higher risk of developing fever, it did not reach statistical significance (p=0.11). Of the 90 neutropenic episodes, 59 (65.6{\%}) developed fever and 25 of these had positive blood cultures. The causative organisms include gram-negative bacteria (64{\%}), gram positive bacteria (16{\%}) and fungus (20{\%}). Of the gram-negative organisms, Klebsiella spp. predominated (28{\%}) with the extended spectrum beta-lactamase producing strain forming the majority (16{\%}). Amongst those with fungaemia, Candida spp. and Candida tropicalis formed the majority (8{\%} each) of the isolates.",
author = "{Abdul Latiff}, Zarina and {Syed Zakaria}, {Syed Zulkifli} and {A. Jamal}, {A. Rahman}",
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T1 - Risk assessment and microbiological profile of infections in paediatric cancer patients with febrile neutropenia.

AU - Abdul Latiff, Zarina

AU - Syed Zakaria, Syed Zulkifli

AU - A. Jamal, A. Rahman

PY - 2002

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AB - Febrile neutropenia is a common and potentially fatal problem encountered in cancer patients undergoing chemotherapy. We carried out an observational study to evaluate the possible risk factors of developing fever amongst neutropenic children with an underlying malignancy. We also looked at the microbiological profile of causative pathogens in patients with febrile neutropenia. During a study period of 1 year, a total of 90 neutropenic episodes were recorded amongst 57 patients who were on treatment and follow-up during the study period. Multivariate analysis showed that factors such as chemotherapy status, underlying disease, existing central venous catheters, presenting white blood cell counts at chemotherapy, use of steroid therapy or hospitalisation at the onset of neutropenia, were not significant risk factors for developing fever during neutropenic episodes. Although the presence of a central venous catheter was associated with a higher risk of developing fever, it did not reach statistical significance (p=0.11). Of the 90 neutropenic episodes, 59 (65.6%) developed fever and 25 of these had positive blood cultures. The causative organisms include gram-negative bacteria (64%), gram positive bacteria (16%) and fungus (20%). Of the gram-negative organisms, Klebsiella spp. predominated (28%) with the extended spectrum beta-lactamase producing strain forming the majority (16%). Amongst those with fungaemia, Candida spp. and Candida tropicalis formed the majority (8% each) of the isolates.

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