Hoecker J L, Pickering L K, Groschel D, Kohl S, van Eys J
Cancer. 1979 Nov;44(5):1939-44. doi: 10.1002/1097-0142(197911)44:5<1939::aid-cncr2820440557>3.0.co;2-l.
One hundred fifteen episodes of bacteremia occurred among 2790 children with malignancies hospitalized during a 45-month period. The mean age was 9.3 years with a male predilection (62%). A greater (p less than .025) number of children over 10 years of age died with bacteremia when compared to younger children. The majority of episodes occurred in children with leukemia (56%); however, once bacteremia developed, a significantly (p less than .05) greater number of children with lymphoma died when compared to children with other malignancies. Absolute polymorphonuclear leukocyte counts were greater in survivors (p less than .025) than in children who died. Thirty-seven different microorganisms were isolated with E. coli, S. Aureus, P. aeruginosa, and K. pneumoniae accounting for 50% of the episodes. Anaerobes were isolated from blood of 12 (10%) children. Twelve children had polymicrobial bacteremia and 14 had recurrent bacteremia which occurred during antibiotic therapy. Mortality (78%) in these children was significantly (p less than .001) greater then in children from whom one microorganism was isolated (47%). Interesting aspects include the resurgence of S. aureus, failure of development of meningitis in children with bacteremia, and unchanged antibiotic susceptibility since the last review of bacteremia in this institution. Polymicrobial and recurrent bacteremia necessitate obtaining simultaneous and sequential blood cultures to facilitate administration of appropriate antimicrobial therapy until bone marrow function improves.
在45个月的时间里，2790名患恶性肿瘤的儿童住院期间发生了115次菌血症。平均年龄为9.3岁，男性居多（62%）。与年幼患儿相比，10岁以上患菌血症死亡的儿童数量更多（p<0.025）。大多数菌血症发作发生在白血病患儿中（56%）；然而，一旦发生菌血症，与其他恶性肿瘤患儿相比，淋巴瘤患儿的死亡数量显著更多（p<0.05）。幸存者的绝对多形核白细胞计数高于死亡儿童（p<0.025）。分离出37种不同的微生物，大肠杆菌、金黄色葡萄球菌、铜绿假单胞菌和肺炎克雷伯菌占发作次数的50%。从12名（10%）儿童的血液中分离出厌氧菌。12名儿童患有多种微生物菌血症，14名儿童在抗生素治疗期间发生复发性菌血症。这些儿童的死亡率（78%）显著高于分离出一种微生物的儿童（47%）（p<0.001）。有趣的方面包括金黄色葡萄球菌的再次出现、菌血症患儿未发生脑膜炎、自该机构上次审查菌血症以来抗生素敏感性未变。多种微生物和复发性菌血症需要同时和连续进行血培养，以便在骨髓功能改善之前促进给予适当的抗菌治疗。
