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Risk assessment and microbiological profile of infections in paediatric cancer patients with febrile neutropenia

Zarina Latiff, and Zulkifli SZ , and Rahman Jamal, (2002) Risk assessment and microbiological profile of infections in paediatric cancer patients with febrile neutropenia. Malaysian Journal of Pathology, 24 (2). pp. 83-89. ISSN 0126-8635

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Official URL: http://www.mjpath.org.my/past_issue/MJP2002.2/Risk%20assessment%20and%20microbiological%20profile.pdf

Affiliations

Universiti Kebangsaan Malaysia. Faculty of Medicine. Dept. of Paediatrics
Universiti Kebangsaan Malaysia. Faculty of Medicine. Dept. of Paediatrics
Universiti Kebangsaan Malaysia. Faculty of Medicine. Dept. of Paediatrics

Abstract

Febrile neutropenia is a common and potentially fatal problem encountered in cancer patients undergoing chemotherapy. We carried out an observational study to evaluate the possible risk factors of developing fever amongst neutropenic children with an underlying malignancy. We also looked at the microbiological profile of causative pathogens in patients with febrile neutropenia. During a study period of 1 year, a total of 90 neutropenic episodes were recorded amongst 57 patients who were on treatment and follow-up during the study period. Multivariate analysis showed that factors such as chemotherapy status, underlying disease, existing central venous catheters, presenting white blood cell counts at chemotherapy, use of steroid therapy or hospitalisation at the onset of neutropenia, were not significant risk factors for developing fever during neutropenic episodes. Although the presence of a central venous catheter was associated with a higher risk of developing fever, it did not reach statistical significance (p=0.11). Of the 90 neutropenic episodes, 59 (65.6%) developed fever and 25 of these had positive blood cultures. The causative organisms include gramnegative bacteria (64%), gram positive bacteria (16%) and fungus 20%). Of the gram-negative organisms, Klebsiella spp. predominated (28%) with the extended spectrum beta- actamase producing strain forming the majority (16%). Amongst those with fungaemia, Candida spp. and Candida tropicalis formed the majority (8% each) of the isolates.

Item Type:Journal
Keywords:Microbiological profile, infections, febrile neutropenia, paediatric cancers
Subjects:R Medicine, Dentistry, Pharmacy, Nursing
ID Code:1815

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