Bacteremia and fungemia in pediatric versus adult cancer patients after chemotherapy: Comparison of etiology, risk factors and outcome

被引：21

作者：

Krupova, I ^{[1
]}

Kaiserova, E ^{[1
]}

Foltinova, A ^{[1
]}

Kovacicova, G ^{[1
]}

Kiskova, M ^{[1
]}

Krchnakova, A ^{[1
]}

Kunova, A ^{[1
]}

Trupl, J ^{[1
]}

West, D ^{[1
]}

Krcmery, V ^{[1
]}

机构：

[1] Childrens Hosp, Natl Pediat Canc Ctr, Bratislava, Slovakia

来源：

JOURNAL OF CHEMOTHERAPY | 1998年 / 10卷 / 03期

关键词：

bacteremia; fungemia; quinolones; leukemia;

D O I：

10.1179/joc.1998.10.3.236

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

One hundred and eighteen (118) episodes of bacteremia and fungemia in children with cancer were compared to 401 episodes of bacteremia and fungemia in adults with cancer;to assess differences in etiology, risk factors and outcome. A retrospective univariate analysis was performed of all episodes of bacteremia in national pediatric and adult cancer institutions appearing in 1990-1996. A total of 519 episodes of bacteremia were assessed and compared. Both cancer centers differed in prophylactic antibiotic policies. About 50% of adults but less than 5% of children received quinolone prophylaxis during neutropenia, even though the empiric antibiotic therapeutic strategy was similar. There were differences in etiology between the groups: staphylococci and Stenotrophomonas maltophilia were more frequently observed in children (P<0.01), Pseudomonas aeruginosa and Acinetobacter spp, in adults (P<0.05). Gram-positive bacteremia was surprisingly more commonly observed in adults (65.7% vs 33.3%, P<0.01). Mixed polymicrobial bacteremia occurred more commonly in adults (31.8% vs 7.6%, P<0.001) than in children. Analysis of risk factors did not observe differences in risk factors except for underlying disease (acute leukemia was more frequently observed in children - 48.3% vs adults 33,7%, P<0.05 and prophylaxis: (prior prophylaxis with quinolones was more common in adults (47.5%) than in children (2.5%) P<0.0001). Overall and attributable mortality in pediatric bacteremia was significantly lower than in adults (P<0.03).

引用

页码：236 / 242

页数：7

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