High frequency of streptococcal bacteraemia during childhood AML therapy irrespective of dose of cytarabine
| Autor: | Johannsen, Katrine Helle, Handrup, Mette Møller, Lausen, Birgitte Frederiksen, Schrøder, Henrik, Hasle, Henrik |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Zdroj: | Johannsen, K H, Handrup, M M, Lausen, B F, Schrøder, H & Hasle, H 2013, ' High frequency of streptococcal bacteraemia during childhood AML therapy irrespective of dose of cytarabine ', Pediatric Blood & Cancer, vol. 60, no. 7, pp. 1154-60 . https://doi.org/10.1002/pbc.24448 |
| DOI: | 10.1002/pbc.24448 |
| Popis: | BACKGROUND: High-dose cytarabine has been associated with a high frequency of viridans group streptococcal (VGS) bacteraemia. VGS bacteraemia causes considerable morbidity and mortality. The Nordic Society of Paediatric Haematology and Oncology (NOPHO)-AML protocols use higher cumulated doses of cytarabine and more chemotherapy series (n = 6) than other protocols with the potential increased risk of severe VGS infections. PROCEDURE: Medical records of all Danish children enrolled on the NOPHO-AML-2004 protocol between January 2004 and September 2011 (n = 45) were retrospectively reviewed and all febrile episodes were registered. RESULTS: Following 236 courses of chemotherapy, 112 positive blood cultures were registered. VGS were found in 38% of all positive blood cultures. Infectious episodes with VGS resulted in more days of fever and intravenous antibiotic therapy compared with infections caused by other microorganisms. VGS were involved in 45% of all episodes categorized as sepsis (n = 51) and in 67% of life-threatening bloodstream infections (n = 9). Penicillin resistance was found in 40% of the VGS strains. No significant difference was observed in the proportion of VGS isolated following courses with low-dose cytarabine versus courses with high-dose cytarabine. CONCLUSIONS: VGS were the most commonly isolated pathogens causing the most severe infections and the majority of life-threatening infections. A substantial proportion of the strains were resistant to penicillin. The high rate of VGS seemed independent of high-dose cytarabine but was more likely caused by the intensive chemotherapy treatment leading to severe mucositis and neutropenia. Pediatr Blood Cancer © 2012 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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