Bacteremia in Febrile, Non-neutropenic, and Well-appearing Children With Cancer
Autor: | Alison F Marshall, Ibis D Lopez, Zhezhen Jin, Melissa Beauchemin, Angela Ricci, Alice Lee, Yujing Yao, Maria Luisa Sulis |
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Rok vydání: | 2021 |
Předmět: |
Male
Catheterization Central Venous medicine.medical_specialty Fever medicine.medical_treatment Bacteremia Article Neoplasms Internal medicine White blood cell medicine Central Venous Catheters Humans Outpatient clinic Child Retrospective Studies business.industry Cancer Hematology Emergency department medicine.disease Pediatric cancer Anti-Bacterial Agents medicine.anatomical_structure Oncology Child Preschool Pediatrics Perinatology and Child Health Cohort Female business Central venous catheter |
Zdroj: | J Pediatr Hematol Oncol |
ISSN: | 1077-4114 |
Popis: | Fever in a neutropenic pediatric oncology patient requires prompt assessment due to the risk of infectious complications. The appropriate management of fever in non-neutropenic patients, however, is not well-established. We describe the rate of bacteremia in a cohort of non-neutropenic pediatric oncology patients with fever at a large institution. Patients were included if they presented to the emergency department or outpatient clinic between 2009 – 2014 with fever, had a central venous catheter (CVC), and were not neutropenic. Three hundred and eighty-six episodes of fever occurring in 159 patients were included in the data analysis. Fifty-nine percent of patients were male, 41% had a diagnosis of acute lymphoblastic leukemia, and 90% had a port-a-cath as CVC. The rate of bacteremia was 3.4%; presence of a port-a-cath was protective against bacteremia whereas a white blood cell count >20,000/mm(3) was associated with a higher likelihood of bacteremia. Gram-positive micro-organisms were most commonly isolated (64.3%) and frequently resistant to cephalosporins. In summary, in our study, the rate of bacteremia was low among non-neutropenic, well-appearing pediatric cancer patients with a CVC and was not associated with any serious medical complications. Prospective research is needed to determine the most appropriate management of these patients. |
Databáze: | OpenAIRE |
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