Agentes causantes de bacteriemia en niños con cáncer y neutropenia febril de alto riesgo en seis hospitales de Santiago, Chile, período 2004-2009 / Bloodstream infections in children with cancer and high risk fever and neutropenia episodes in six hospitals of Santiago, Chile between 2004 and 2009
Rev. chil. infectol
; 29(2): 156-162, abr. 2012. graf, tab
Article
in Spanish
| LILACS
| ID: lil-627228
Responsible library:
CL1.1
ABSTRACT
Introduction:
To determine the etiology of invasive bacterial infection in high risk febrile neutropenia (HRFN) episodes in children with cancer is essential because of the favorable impact on mortality of the early empiric antibiotic treatment.Objective:
To determine the etiology of bacteremia in pediatric patients with cancer and HRFN in the National Child Program of Antineoplastic Drugs during the 2004-2009 period, and compare these agents and their antimicrobial susceptibility with the period 1994-1998 described in a previous study.Methods:
The causative agents of bacteremia were prospectively recorded in patients less than 18 years of age receiving chemotherapy for cancer with HRFN and positive blood cultures admitted to one of the six hospitals from the Child Program of Antineoplastic Drugs network during the period 2004-2009.Results:
839 episodes of HRFN were identified; 181 blood cultures were positive in the following proportion gram positive cocci (56%), gram negative bacilli (42%) and yeast (2%).The most common etiologic agents were Staphylococcus coagulase negative (25%), Escherichia. coli (20%), group viridans Streptococcus (14%), Staphylococcus aureus (13%) and Pseudomonas aeruginosa (9%). Comparing the two periods, the relative frequency of Streptococcus spp increased from 4 to 17%, coagulase negative Staphylococcus decreased from 44 to 25%, showing an increase in their resistance to oxacillin from 55% to 77%.Conclusions:
We describe the main etiological agents from HRFN episodes in children with cancer in a 5 years period. This information could help for a better approach in the empirical antimicrobial therapy in this population.RESUMEN
Introducción:
Conocer la etiología de los episodios de neutropenia febril de alto riesgo (NFAR) en pacientes con cáncer tiene importancia para implementar tratamientos antimicrobianos ajustados a la epidemiología local, lo que tiene impacto en la morbilidad y mortalidad.Objetivo:
Describir la etiología de las bacteriemias en niños con cáncer y NFAR en el período 2004-2009, en la red PINDA de Santiago (Región Metropolitana), Chile, y comparar estos agentes y su susceptibilidad antimicrobiana con un estudio previo realizado en el período 1994-1998. Material yMétodos:
Se registraron prospectivamente los agentes causantes de bacteriemia y su susceptibilidad a antimicrobianos de los pacientes bajo 18 años de edad en tratamiento quimioterápico por cáncer, ingresados con diagnóstico de NFAR a los seis hospitales de la red, durante el período 2004-2009.Resultados:
De 839 episodios de NFAR, 181 tuvieron hemocultivos positivos, correspondientes a cocáceas grampositivas (56%), bacilos gramnegativos (42%) y levaduras (2%). Los agentes más frecuentemente aislados fueron Staphylococcus coagula-sa negativa (25%), Escherichia coli (20%), Streptococcus grupo viridans (14%), Staphylococcus aureus (13%) y Pseudomonas spp (9%). Al comparar los dos períodos de tiempo, destacan los siguientes cambios significativos disminución en frecuencia relativa de Staphylococcus coagulasa negativa (desde 44 a 25%), aumento de Streptococcus spp (desde 4 a 17%), y aumento de la resistencia de Staphylococcus coagulasa negativa a oxacilina (desde 55 a 77%).Conclusiones:
Se dan a conocer los principales agentes etiológicos de los episodios de NFAR y la susceptibilidad a antimicrobianos en un período de cinco años. Esto permite racionalizar el manejo antimicrobiano empírico de los episodios de NFAR en esta población.
Full text:
Available
Collection:
International databases
Health context:
SDG3 - Health and Well-Being
/
SDG3 - Target 3.3 End transmission of communicable diseases
/
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
/
SDG3 - Target 3.2 Reduce avoidable death in newborns and children under 5
Health problem:
Target 3.2: Reduce avoidable death in newborns and children under 5
/
Sepsis
/
Other Blood Disorders
/
Infections
/
Neonatal Healthcare
Database:
LILACS
Main subject:
Bacteremia
/
Fever
/
Gram-Negative Bacteria
/
Gram-Positive Bacteria
/
Neoplasms
/
Neutropenia
Type of study:
Controlled clinical trial
/
Etiology study
/
Observational study
/
Risk factors
Limits:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Chile
Language:
Spanish
Journal:
Rev. chil. infectol
Journal subject:
Communicable Diseases
Year:
2012
Document type:
Article
/
Project document
Affiliation country:
Chile
Institution/Affiliation country:
Complejo Hospitalario Dr. Sótero Del Río/CL
/
Hospital Clínico San Borja-Arriarán/CL
/
Hospital Dr. Exequiel González Cortés/CL
/
Hospital Dr. Luis Calvo Mackenna/CL
/
Hospital Dr. Roberto Del Río/CL
/
Hospital San Juan de Dios/CL
/
Universidad de Chile/CL