PREVALENCE OF PATHOGENS IN PEDIATRIC CANCER PATIENTS WITH FEBRILE NEUTROPENIA

Febrile neutropenia (FN) is an important clinical problem in pediatric cancer patients who have been treated with chemotherapy. This study set forth to investigate the characteristics of FN, the sources of infection, and the prevalence of causative agents in pediatric cancer patients with FN. This retrospective chart review was conducted in pediatric cancer patients under 15 years of age who developed an episode of FN and who were treated at the Department of Pediatrics, Siriraj Hospital (Bangkok, Thailand) during the January 2005 to September 2013 study period. There were 214 episodes of FN from 179 patients. Median temperature at diagnosis was 38.9 degrees C (range: 38.3-41). Of all FN episodes, 44.4% had initial absolute neutrophil count (ANC) <100 cell/mm(3), and 10.8% had identifiable causes of infection. Respiratory tract was the most common site of infection, and influenza virus was the most prevalent identifiable organism. Septicemia occurred in 5.61 % of cases, and the most common type of pathogen was gram-positive bacteria. A majority of cases (77.5%) responded well to initial empirical antibiotic treatment. Two patients (0.93%) died from serious infection. Good response to treatment and low mortality was observed among the pediatric cancer patients with FN that were included in this study. Laboratory evaluation for viral pathogen, especially in patients with signs and symptoms of respiratory tract infection, should be strongly considered. A shift in tendency from gram-negative to gram-positive bacteria as the common pathogens in bacteremia is also emphasized.