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Microbiology and mortality of pediatric febrile neutropenia in El Salvador.
- Source :
-
Journal of pediatric hematology/oncology [J Pediatr Hematol Oncol] 2011 May; Vol. 33 (4), pp. 276-80. - Publication Year :
- 2011
-
Abstract
- Background: Febrile neutropenia (FN) and infection-related mortality are major problems for children with cancer in low-income countries. Identifying predictors for adverse outcome of FN in low-income countries permits targeted interventions. We describe the nature and predictors of microbiologically documented infection (MDI) and mortality of FN in children with cancer in El Salvador.<br />Methods: We examined Salvadoran pediatric oncology patients admitted with FN over a 1-year period. Data were collected prospectively. Demographic, treatment, and admission-related variables were examined as predictors of outcomes.<br />Results: Hundred six FN episodes among 85 patients were included. Twenty-three of 106 episodes (22%) were microbiologically documented; 13 of 106 episodes (12%) resulted in death. Gram-positive and gram-negative organisms were isolated in 14 of 23 and 11 of 23 specimens; polymicrobial infections were common (11 of 23 episodes of MDI). Older age decreased the MDI risk [odds ratio (OR) per year=0.87, 95% confidence interval (CI), 0.75-0.99; P=0.04] while increasing number of days since the last chemotherapy increased the risk (OR=1.03 per day, 95% CI, 1.01-1.04; P=0.002). Pneumonia diagnosed either clinically (OR=6.6, 95% CI, 1.8-30.0; P=0.005) or radiographically (OR=5.5, 95% CI, 1.7-18.1; P=0.005) was the only predictor of mortality.<br />Conclusions: In El Salvador, polymicrobial infections were common. Pneumonia at admission identified children with FN at high risk of death; these children may benefit from targeted interventions.
- Subjects :
- Adolescent
Child
Child, Preschool
El Salvador epidemiology
Female
Fever immunology
Fever microbiology
Gram-Negative Bacterial Infections immunology
Gram-Positive Bacterial Infections immunology
Humans
Infant
Male
Neoplasms immunology
Neutropenia immunology
Pneumonia, Bacterial immunology
Pneumonia, Bacterial mortality
Predictive Value of Tests
Prevalence
Risk Factors
Fever mortality
Gram-Negative Bacterial Infections mortality
Gram-Positive Bacterial Infections mortality
Neoplasms mortality
Neutropenia mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1536-3678
- Volume :
- 33
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of pediatric hematology/oncology
- Publication Type :
- Academic Journal
- Accession number :
- 21516023
- Full Text :
- https://doi.org/10.1097/MPH.0b013e31820ff632