发热性中性粒细胞减少症患儿菌血症的危险因素。
Risk factors for bacteremia in children with febrile neutropenia.
机构信息
Department of Pediatric Infectious Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
Department of Pediatric Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
出版信息
Turk J Med Sci. 2019 Aug 8;49(4):1198-1205. doi: 10.3906/sag-1901-90.
BACKGROUND/AIM: Bacteremia remains an important cause of morbidity and mortality during febrile neutropenia (FN) episodes. We aimed to define the risk factors for bacteremia in febrile neutropenic children with hemato-oncological malignancies.
MATERIALS AND METHODS
The records of 150 patients aged ≤18 years who developed FN in hematology and oncology clinics were retrospectively evaluated. Patients with bacteremia were compared to patients with negative blood cultures.
RESULTS
The mean age of the patients was 7.5 ± 4.8 years. Leukemia was more prevalent than solid tumors (61.3% vs. 38.7%). Bacteremia was present in 23.3% of the patients. Coagulase-negative staphylococci were the most frequently isolated microorganism. Leukopenia, severe neutropenia, positive peripheral blood and central line cultures during the previous 3 months, presence of a central line, previous FN episode(s), hypotension, tachycardia, and tachypnea were found to be risk factors for bacteremia. Positive central line cultures during the previous 3 months and presence of previous FN episode(s) were shown to increase bacteremia risk by 2.4-fold and 2.5-fold, respectively.
CONCLUSION
Presence of a bacterial growth in central line cultures during the previous 3 months and presence of any previous FN episode(s) were shown to increase bacteremia risk by 2.4-fold and 2.5-fold, respectively. These factors can predict bacteremia in children with FN.
背景/目的：菌血症仍然是发热性中性粒细胞减少症（FN）发作期间发病率和死亡率的重要原因。我们旨在确定血液恶性肿瘤和恶性肿瘤患者发生 FN 时菌血症的危险因素。
材料和方法
回顾性评估了 150 名年龄≤18 岁在血液科和肿瘤科诊所发生 FN 的患者的记录。将发生菌血症的患者与血培养阴性的患者进行比较。
结果
患者的平均年龄为 7.5 ± 4.8 岁。白血病比实体瘤更为常见（61.3%比 38.7%）。23.3%的患者存在菌血症。凝固酶阴性葡萄球菌是最常分离的微生物。白细胞减少症、严重中性粒细胞减少症、前 3 个月外周血和中心导管培养阳性、中心导管存在、前 FN 发作、低血压、心动过速和呼吸急促被认为是菌血症的危险因素。前 3 个月的中心导管培养阳性和前 FN 发作存在被证明分别使菌血症风险增加 2.4 倍和 2.5 倍。
结论
前 3 个月中心导管培养中存在细菌生长和任何既往 FN 发作均使菌血症风险分别增加 2.4 倍和 2.5 倍。这些因素可以预测 FN 患儿的菌血症。
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