Causative Pathogens of Febrile Neutropaenia in Children Treated for Acute Lymphoblastic Leukaemia
Annals of the Academy of Medicine, Singapore
; : 530-534, 2015.
Article
en En
| WPRIM
| ID: wpr-309483
Biblioteca responsable:
WPRO
ABSTRACT
<p><b>INTRODUCTION</b>Treatment of acute lymphoblastic leukaemia (ALL) using intensive chemotherapy has resulted in high cure rates but also substantial morbidity. Infective complications represent a significant proportion of treatment-related toxicity. The objective of this study was to describe the microbiological aetiology and clinical outcome of episodes of chemotherapy-induced febrile neutropaenia in a cohort of children treated for ALL at our institution.</p><p><b>MATERIALS AND METHODS</b>Patients with ALL were treated with either the HKSGALL93 or the Malaysia-Singapore (Ma-Spore) 2003 chemotherapy protocols. The records of 197 patients who completed the intensive phase of treatment, defined as the period of treatment from induction, central nervous system (CNS)-directed therapy to reinduction from June 2000 to January 2010 were retrospectively reviewed.</p><p><b>RESULTS</b>There were a total of 587 episodes of febrile neutropaenia in 197 patients, translating to an overall rate of 2.98 episodes per patient. A causative pathogen was isolated in 22.7% of episodes. An equal proportion of Gram-positive bacteria (36.4%) and Gram-negative bacteria (36.4%) were most frequently isolated followed by viral pathogens (17.4%), fungal pathogens (8.4%) and other bacteria (1.2%). Fungal organisms accounted for a higher proportion of clinically severe episodes of febrile neutropaenia requiring admission to the high-dependency or intensive care unit (23.1%). The overall mortality rate from all episodes was 1.5%.</p><p><b>CONCLUSION</b>Febrile neutropaenia continues to be of concern in ALL patients undergoing intensive chemotherapy. The majority of episodes will not have an identifiable causative organism. Gram-positive bacteria and Gram-negative bacteria were the most common causative pathogens identified. With appropriate antimicrobial therapy and supportive management, the overall risk of mortality from febrile neutropaenia is extremely low.</p>
Texto completo:
1
Base de datos:
WPRIM
Asunto principal:
Infecciones por Pseudomonas
/
Singapur
/
Infecciones Estafilocócicas
/
Infecciones por Klebsiella
/
Virosis
/
Candidiasis
/
Epidemiología
/
Estudios Retrospectivos
/
Estudios de Cohortes
/
Infecciones por Bacterias Grampositivas
Tipo de estudio:
Etiology_studies
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Child
/
Humans
País/Región como asunto:
Asia
Idioma:
En
Revista:
Annals of the Academy of Medicine, Singapore
Año:
2015
Tipo del documento:
Article