Cortés Daniel, Maldonado María Eliana, Rivacoba María Carolina, Maza Verónica de la, Valenzuela Romina, Payá Ernesto, Contardo Verónica, Álvarez Ana María, Avilés Carmen Luz, Becker Ana, Salgado Carmen, Tordecilla Juan, Varas Mónica, Venegas Marcela, Villarroel Milena, Viviani Tamara, Zubieta Marcela, Santolaya María Elena
Programa de título de especialistas en Infectología pediátrica, Facultad de Medicina, Universidad de Chile, Chile.
Hospital Dr. Exequiel González Cortés, Facultad de Medicina, Universidad de Chile, Chile.
Rev Chilena Infectol. 2020 Aug;37(4):383-388. doi: 10.4067/S0716-10182020000400383.
Viridans group streptococci (VGS) has acquired relevance as a microorganism causing febrile neutropenia, associated with significant morbidity.
To characterize episodes of bacteremia caused by VGS in children with cancer who developed high-risk febrile neutropenia (HRFN) during the period from April 2004 to June 2018 in six pediatric hospitals of Santiago, Chile.
Database analysis of 4 successive, prospective and multicentric studies recording clinical and laboratory characteristics of patients, as well as antimicrobial susceptibility pattern of isolated strains.
95 episodes of VGS bacteremia in 91 children with HRFN were analyzed. It emphasizes acute myeloid leukemia as cancer type, deep neutropenia, prolonged hospitalization (15 days), with extended use of antimicrobials (14 days) and use of cytarabine in chemotherapy schemes (86% episodes). The most frequent clinical manifestations were respiratory and gastrointestinal, associating up to 26% viridans group shock syndrome. There was high resistance to β lactams. As expected, there were not non-susceptible strains to vancomycin.
VGS is a relevant microorganism in children with cancer, fever and neutropenia, with a high percentage of sepsis. Resistance to β lactams is an issue that requires strict epidemiological surveillance in this population.
