| Bacteremia in febrile nonneutropenic pediatric oncology patients. | |
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MedLine Citation:
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PMID: 19774640 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: We sought to determine the risk of bacteremia in a cohort of outpatient febrile nonneutropenic pediatric oncology patients and to assess clinical characteristics that may influence decisions regarding empiric antibiotic therapy. PROCEDURE: A single institution retrospective cohort study was performed of outpatient pediatric oncology patients presenting with fever, a central venous catheter, and an absolute neutrophil count (ANC) of >/=500/microl over a 6-year period. We also collected data regarding the presence of clinically evident infections, antibiotics prescribed, and the sensitivity of bacteria to specific antibiotics. RESULTS: There were 29 cases of bacteremia in 459 (6.3%) febrile outpatient visits by 167 patients. Bacteremia was documented in 4.4% of patients with ports and in 16.2% of patients with external catheters. Patients with external catheters had a relative risk of bacteremia of 3.7 (95% CI: 1.8-7.4) times the risk of those with internal catheters (P < 0.0001). A documented source for fever on exam was noted in 21% of patients but in none of the patients with bacteremia (P = 0.004). Empiric treatment with ceftriaxone was administered to 92% of the patients. Of the high-risk bacteremic infections (Gram-negative organisms, Streptococcus pneumoniae, viridans group streptococcus, and Staphylococcus aureus) 94% had at least an intermediate sensitivity to ceftriaxone. CONCLUSIONS: Bacteremia is an important issue in febrile nonneutropenic pediatric oncology patients occurring in 6% of the patient visits in this study. The overall sensitivity of high-risk bacteremia to ceftriaxone provides justification for its empiric use in outpatient febrile nonneutropenic pediatric oncology patients. |
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Authors:
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Michael J Kelly; Patrick M Vivier; Tali M Panken; Cindy L Schwartz |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Pediatric blood & cancer Volume: 54 ISSN: 1545-5017 ISO Abbreviation: Pediatr Blood Cancer Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2009-11-17 Completed Date: 2009-12-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101186624 Medline TA: Pediatr Blood Cancer Country: United States |
Other Details:
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Languages: eng Pagination: 83-7 Citation Subset: IM |
Copyright Information:
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Copyright 2009 Wiley-Liss, Inc. |
Affiliation:
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Department of Pediatric Hematology Oncology, Hasbro Children's Hospital, Providence, RI 02903, USA. michael_kelly@brown.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Anti-Bacterial Agents / therapeutic use Bacteremia / diagnosis, drug therapy, etiology* Bacteria / pathogenicity* Child Child, Preschool Cohort Studies Female Fever / diagnosis, drug therapy, etiology* Humans Infant Infant, Newborn Male Neoplasms / complications*, microbiology* Neutrophils / drug effects, microbiology* Retrospective Studies Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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