Update on Healthcare-Associated Blood Stream Infections in Febrile Neutropenic Pediatric Oncology Patients  

作　　者：Hadir A. El-Mahallawy Safaa Shawky Hassan Mohamed El-Wakil Manar M. Moneer Lobna Shalaby 

机构地区：[1]Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt [2]Clinical Oncology Department, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt [3]Biostatistics and Cancer Epidemiology Department, National Cancer Institute, Cairo University, Cairo, Egypt [4]Pediatric Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt

出　　处：《Journal of Cancer Therapy》2015年第6期504-510,共7页癌症治疗（英文）

摘　　要：Background: Continuous surveillance of pattern of blood stream infection is necessary in febrile neutropenia especially with the recent escalating trend in the management of pediatric cancer patients towards intensified regimens and with the increase in infections caused by resistant organisms limiting the choice of antibiotics. Aim: Monitoring if a change has occurred in pattern of blood stream infections (BSI) in febrile neutropenic (FN) pediatric cancer patients. Methods: Surveillance of FN episodes with positive BSI was prospectively monitored and compared to a previous surveillance in the same pediatric oncology unit. Results: A total of 232 BSI positive episodes were documented in 192 patients during a 6 months period. The results of recent surveillance analysis showed an increase in intensified regimens of chemotherapy, antimicrobial resistance, and prolonged duration of episodes when compared to previous surveillance, with a p value of <0.001, 0.005, and <0.001, respectively. There was an apparent decrease in the crude mortality but this was not statistically significant, 6% in 2011 and 10% in 2006. Conclusion: The pattern of BSI at our institution is still inclining towards gram positive organisms but is showing a shift towards more antibiotic resistance and prolonged episodes.Background: Continuous surveillance of pattern of blood stream infection is necessary in febrile neutropenia especially with the recent escalating trend in the management of pediatric cancer patients towards intensified regimens and with the increase in infections caused by resistant organisms limiting the choice of antibiotics. Aim: Monitoring if a change has occurred in pattern of blood stream infections (BSI) in febrile neutropenic (FN) pediatric cancer patients. Methods: Surveillance of FN episodes with positive BSI was prospectively monitored and compared to a previous surveillance in the same pediatric oncology unit. Results: A total of 232 BSI positive episodes were documented in 192 patients during a 6 months period. The results of recent surveillance analysis showed an increase in intensified regimens of chemotherapy, antimicrobial resistance, and prolonged duration of episodes when compared to previous surveillance, with a p value of <0.001, 0.005, and <0.001, respectively. There was an apparent decrease in the crude mortality but this was not statistically significant, 6% in 2011 and 10% in 2006. Conclusion: The pattern of BSI at our institution is still inclining towards gram positive organisms but is showing a shift towards more antibiotic resistance and prolonged episodes.

关 键 词：Blood Stream Infections (BSI) FEBRILE NEUTROPENIA (FN) MULTIDRUG Resistant ORGANISM (MDRO) 

分 类 号：R73[医药卫生—肿瘤]