TY - JOUR
T1 - Bloodstream infections in children with cancer
T2 - A multicentre surveillance study of the Italian Association of Paediatric Haematology and Oncology
AU - Viscoli, C.
AU - Castagnola, E.
AU - Giacchino, M.
AU - Cesaro, S.
AU - Properzi, E.
AU - Tucci, F.
AU - Mura, R. M.
AU - Alvisi, P.
AU - Zanazzo, G.
AU - Surico, G.
AU - Bonetti, F.
AU - De Sio, L.
AU - Izzi, G.
AU - Di Cataldo, A.
AU - Ziino, O.
AU - Massolo, F.
AU - Nardi, M.
AU - Santoro, N.
AU - Binda, S.
PY - 1999/5
Y1 - 1999/5
N2 - A one-year prospective, multicentre surveillance study on aetiology, main clinical features and outcome of bloodstream infections in children with cancer was conducted in 18 paediatric haematology centres belonging to the Italian Association for Paediatric Haematology and Oncology. A total of 191 bloodstream infections were reported during the study period. Of them, 123 (64%) occurred in neutropenic and 68 (36%) in non-neutropenic patients. Gram- positive cocci caused 45% (85/191) of the episodes, gram-negative rods 41% (78/191), and fungi 9% (18/191). The remaining 5% (10/191) of the episodes were poly-microbial infections. A total of 204 pathogens were isolated (46% gram-positive cocci; 44% gram-negative rods; and 10% fungi). The aetiologic distribution was similar among neutropenic and non-neutropenic patients. A correlation between the infection and the presence of an indwelling central venous catheter was found in 20% (23/114) of the episodes among neutropenic patients and in 55% (23/62) among non-neutropenic patients. Gram-negative micro-organisms were isolated in an unusually high proportion of catheter- related infections (48%). The overall mortality rate from any cause within 30 days from the first positive blood culture was 11%, and was higher among patients who were neutropenic at the onset of the infection than among those who were not neutropenic (15 versus 4%, P = 0.03). In addition, the mortality was significantly higher in recipients of bone marrow transplantation than in patients with acute leukaemia or solid tumour (21, 11 and 6%, respectively) and was also higher in fungaemias and poly-microbial infections (22 and 30%) than in single gram-positive and gram-negative bacteraemias (11 and 6%).
AB - A one-year prospective, multicentre surveillance study on aetiology, main clinical features and outcome of bloodstream infections in children with cancer was conducted in 18 paediatric haematology centres belonging to the Italian Association for Paediatric Haematology and Oncology. A total of 191 bloodstream infections were reported during the study period. Of them, 123 (64%) occurred in neutropenic and 68 (36%) in non-neutropenic patients. Gram- positive cocci caused 45% (85/191) of the episodes, gram-negative rods 41% (78/191), and fungi 9% (18/191). The remaining 5% (10/191) of the episodes were poly-microbial infections. A total of 204 pathogens were isolated (46% gram-positive cocci; 44% gram-negative rods; and 10% fungi). The aetiologic distribution was similar among neutropenic and non-neutropenic patients. A correlation between the infection and the presence of an indwelling central venous catheter was found in 20% (23/114) of the episodes among neutropenic patients and in 55% (23/62) among non-neutropenic patients. Gram-negative micro-organisms were isolated in an unusually high proportion of catheter- related infections (48%). The overall mortality rate from any cause within 30 days from the first positive blood culture was 11%, and was higher among patients who were neutropenic at the onset of the infection than among those who were not neutropenic (15 versus 4%, P = 0.03). In addition, the mortality was significantly higher in recipients of bone marrow transplantation than in patients with acute leukaemia or solid tumour (21, 11 and 6%, respectively) and was also higher in fungaemias and poly-microbial infections (22 and 30%) than in single gram-positive and gram-negative bacteraemias (11 and 6%).
KW - Bacteraemia
KW - Cancer infections
KW - Fungaemia
UR - http://www.scopus.com/inward/record.url?scp=0033062275&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033062275&partnerID=8YFLogxK
U2 - 10.1016/S0959-8049(99)00052-0
DO - 10.1016/S0959-8049(99)00052-0
M3 - Article
C2 - 10505037
AN - SCOPUS:0033062275
VL - 35
SP - 770
EP - 774
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
IS - 5
ER -