Risk factors for bacteremia in children with febrile neutropenia

Turk J Med Sci. 2019 Aug 8;49(4):1198-1205. doi: 10.3906/sag-1901-90.

Abstract

Background/aim: Bacteremia remains an important cause of morbidity and mortality during febrile neutropenia (FN) episodes. We aimed to define the risk factors for bacteremia in febrile neutropenic children with hemato-oncological malignancies.

Materials and methods: The records of 150 patients aged ≤18 years who developed FN in hematology and oncology clinics were retrospectively evaluated. Patients with bacteremia were compared to patients with negative blood cultures.

Results: The mean age of the patients was 7.5 ± 4.8 years. Leukemia was more prevalent than solid tumors (61.3% vs. 38.7%). Bacteremia was present in 23.3% of the patients. Coagulase-negative staphylococci were the most frequently isolated microorganism. Leukopenia, severe neutropenia, positive peripheral blood and central line cultures during the previous 3 months, presence of a central line, previous FN episode(s), hypotension, tachycardia, and tachypnea were found to be risk factors for bacteremia. Positive central line cultures during the previous 3 months and presence of previous FN episode(s) were shown to increase bacteremia risk by 2.4-fold and 2.5-fold, respectively.

Conclusion: Presence of a bacterial growth in central line cultures during the previous 3 months and presence of any previous FN episode(s) were shown to increase bacteremia risk by 2.4-fold and 2.5-fold, respectively. These factors can predict bacteremia in children with FN.

Keywords: Bacteremia; children; febrile neutropenia; risk factor.

MeSH terms

  • Adolescent
  • Bacteremia* / complications
  • Bacteremia* / epidemiology
  • Bacteremia* / physiopathology
  • Chemotherapy-Induced Febrile Neutropenia* / complications
  • Chemotherapy-Induced Febrile Neutropenia* / epidemiology
  • Chemotherapy-Induced Febrile Neutropenia* / physiopathology
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Neoplasms / complications
  • Neoplasms / epidemiology
  • Retrospective Studies
  • Risk Factors