Incidence of septicaemias and invasive mycoses in children undergoing treatment for solid tumours: a 12-year experience at a single Italian institution

Eur J Cancer. 2001 Dec;37(18):2413-9. doi: 10.1016/s0959-8049(01)00274-x.

Abstract

We carried out a retrospective study on the infection rate--in episodes per 100 person months at risk (p/m/r)--of septicaemia and invasive mycoses in children with solid tumours treated at a single institution between 1985 and 1996. Among 982 patients, accounting for 8108 p/m/r, 257 infectious episodes were documented, for an infection rate of 3.2. The infection rate for "intensive" treatment was greater than that for "less intensive" treatments, 3.7 compared with 0.5, respectively; P<0.001. 58% of infectious episodes were associated with neutropenia, 22% were megatherapy-related, and 39% were related to central venous catheter (CVC), while in 13% of the episodes no risk factor was identified. Of the episodes, single organism Gram-positive bacteraemias accounted for 62%, single organism Gram-negative for 23%, multiple organism bacteraemias for 7%, invasive mycoses for 4%, and isolated fungaemias for 4%. The infection rate for Gram-positive organisms decreased significantly over time (-5.9% per year; P<0.01), but increased for the Gram-negative organisms (+3.4% per year; P=0.4). This study demonstrates that the risk of bacteraemia increases in parallel with the treatment intensity, and that a considerable number of children with solid tumours develop bacteraemia in the absence of an identifiable risk factor.

MeSH terms

  • Adolescent
  • Bacteremia / epidemiology*
  • Catheterization, Central Venous
  • Child
  • Child, Preschool
  • Equipment Contamination / prevention & control
  • Fungemia / epidemiology*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Italy / epidemiology
  • Neoplasms / microbiology
  • Neoplasms / therapy*
  • Quality of Health Care
  • Regression Analysis
  • Retrospective Studies
  • Risk Factors