El-Mahallawy Hadir A, Hassan Safaa Shawky, El-Wakil Mohamed, Moneer Manar M, Shalaby Lobna
Clinical Pathology Department, National Cancer Institute, Cairo University Cairo, Egypt E-mail :
Asian Pac J Cancer Prev. 2015;16(14):5691-5. doi: 10.7314/apjcp.2015.16.14.5691.
Continuous surveillance of pattern of blood stream infection is necessary in febrile neutropenia (FN)especially with the recent escalating trend in the management of pediatric cancer patients towards intensified regimens and with the increase in infections caused by resistant organisms limiting the choice of antibiotics.
To monitor change in pattern of blood stream infections (BSI) in FN pediatric cancer patients.
Surveillance of FN episodes with positive BSI was prospectively monitored and compared to a previous surveillance in the same pediatric oncology unit.
A total of 232 BSI positive episodes were documented in 192 patients during a 6 months period. The results of recent surveillance analysis showed an increase in intensified regimens of chemotherapy, antimicrobial resistance, fungal infections, and prolonged duration of episodes when compared to previous surveillance, with p value sof <0.001, 0.005, 0.021, and <0.001, respectively. There was an apparent decrease in the crude mortality but this was not statistically significant, to 6% in 2011 from 10 % in 2006.
The pattern of BSI at our institution is still inclining towards gram positive organisms but is showing a shift towards more antibiotic resistance and fungal infections.
在发热性中性粒细胞减少症（FN）中，持续监测血流感染模式是必要的，尤其是鉴于近期儿科癌症患者的治疗方案朝着强化治疗发展的趋势不断升级，以及耐药菌引起的感染增加限制了抗生素的选择。
监测FN儿科癌症患者血流感染（BSI）模式的变化。
对BSI呈阳性的FN发作进行前瞻性监测，并与同一儿科肿瘤病房之前的监测结果进行比较。
在6个月期间，192例患者共记录到232次BSI阳性发作。近期监测分析结果显示，与之前的监测相比，化疗强化方案、抗菌药物耐药性、真菌感染以及发作持续时间均有所增加，p值分别为<0.001、0.005、0.021和<0.001。粗死亡率明显下降，但无统计学意义，从2006年的10%降至2011年的6%。
我们机构的BSI模式仍倾向于革兰氏阳性菌，但显示出向更多抗生素耐药性和真菌感染转变的趋势。
