Risk Factors of Bloodstream Infection Associated Mortality in Pediatric Patients with Hemato-oncologic Disease / 대한혈액학회지
Korean Journal of Hematology
;
: 343-352, 2007.
Article
in Korean
| WPRIM
| ID: wpr-720995
ABSTRACT
BACKGROUND:
Bloodstream infection is one of the important causes of mortality, and morbidity in pediatric patients with hemato-oncologic disease. The purpose of this study was to identify the risk factors related to mortality in patients who suffered from a bloodstream infection.METHODS:
We retrospectively reviewed and analyzed the medical records of 133 pediatric patients with hemato-oncologic diseases who had episodes of bloodstream infection documented at Asan Medical Center from June 2002 through May 2005.RESULTS:
A total of 288 pathogens were isolated, and there were 17 episodes of polymicrobial infections. Among the episodes of bloodstream infection, 93.4% were caused by bacteria of which 60.1% were gram-positive bacteria, and 33.3% were gram-negative bacteria. Fungal infections accounted for 6.6% of the infections. The main pathogens included Staphylococcus epidermidis (31.3%), Pseudomonas aeruginosa (8.3%), and Klebsiella pneumoniae (7.3%). Gram-positive organisms were isolated more frequently than gram-negative organisms, and non-albicans Candida species were documented more frequently than C. albicans in our study. Infection related mortality was 8.3% (11 of 133 patients). The pulmonary infiltration on chest X-ray (CXR) (P=0.001), and a low absolute neutrophil count (< or = 500/micorL) (P=0.017) at the time of blood culture were significantly associated with mortality. Gram-negative bacterial infection (especially with Stenotrophomonas maltophilia) and fungal infection often progressed to the septic shock or death.CONCLUSION:
This study revealed that the presence of pulmonary infiltration on a CXR, neutropenia (< or = 500/microL), and gram-negative bacterial infection might be important risk factors of mortality in pediatric patients with hemato-oncologic diseases necessitating more aggressive and vigilant supportive care.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pseudomonas aeruginosa
/
Shock, Septic
/
Staphylococcus epidermidis
/
Thorax
/
Bacteria
/
Candida
/
Medical Records
/
Retrospective Studies
/
Risk Factors
/
Mortality
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
Korean
Journal:
Korean Journal of Hematology
Year:
2007
Type:
Article
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