A Prospective Multicenter SPOG 2003 FN Study of Microbiologically Defined Infections in Pediatric Cancer Patients with Fever and Neutropenia.

Détails

Ressource 1Télécharger: BIB_897DB63967F7.P001.pdf (376.70 [Ko])
Etat: Public
Version: de l'auteur⸱e
ID Serval
serval:BIB_897DB63967F7
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
A Prospective Multicenter SPOG 2003 FN Study of Microbiologically Defined Infections in Pediatric Cancer Patients with Fever and Neutropenia.
Périodique
Pediatric Infectious Disease Journal
Auteur⸱e⸱s
Agyeman P., Kontny U., Nadal D., Leibundgut K., Niggli F., Simon A., Kronenberg A., Frei R., Escobar H., Kühne T., Beck-Popovic M., Bodmer N., Ammann R.A.
ISSN
1532-0987 (Electronic)
ISSN-L
0891-3668
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
33
Numéro
9
Pages
e219-e225
Langue
anglais
Notes
pdf: [Original Studies]
Résumé
BACKGROUND: Fever and neutropenia (FN) often complicate anticancer treatment and can be caused by potentially fatal infections. Knowledge of pathogen distribution is paramount for optimal patient management.
METHODS: Microbiologically defined infections (MDI) in pediatric cancer patients presenting with FN by nonmyeloablative chemotherapy enrolled in a prospective multi-center study were analyzed. Effectiveness of empiric antibiotic therapy in FN episodes with bacteremia was assessed taking into consideration recently published treatment guidelines for pediatric patients with FN.
RESULTS: MDI were identified in a minority (22%) of pediatric cancer patients with FN. In patients with, compared to without MDI, fever (median, 5 [IQR 3-8] vs. 2 [IQR1-3] days, p < 0.001) and hospitalization (10 [6-14] vs. 5 [3-8] days, p < 0.001) lasted longer, transfer to the intensive care unit was more likely (13 of 95 [14%] vs. 7 of 346 [2.0%], p < 0.001), and antibiotics were given longer (10 [7-14] vs. 5 [4-7], p < 0.001). Empiric antibiotic therapy in FN episodes with bacteremia was highly effective if not only intrinsic and reported antimicrobial susceptibilities were considered but the purposeful omission of coverage for coagulase negative staphylococci and enterococci was also taken into account (81% [95%CI 68 - 90] vs. 96.6% [95%CI 87 - 99.4], p = 0.004) CONCLUSIONS: MDI were identified in a minority of FN episodes but they significantly affected management and the clinical course of pediatric cancer patients. Compliance with published guidelines was associated with effectiveness of empiric antibiotic therapy in FN episodes with bacteremia.
Pubmed
Web of science
Création de la notice
25/09/2014 16:49
Dernière modification de la notice
20/08/2019 14:48
Données d'usage