Microorganisms isolated from cultures and infection focus and antibiotic treatments in febrile neutropenic children from Şanlıurfa, Turkey

Microorganisms isolated from cultures and infection focus and antibiotic treatments in febrile neutropenic children from Şanlıurfa, Turkey

Özdemir ZC, Koç A, Ayçiçek A. Microorganisms isolated from cultures and infection focus and antibiotic treatments in febrile neutropenic children from Şanlıurfa, Turkey. Turk J Pediatr 2016; 58: 47-53.Chemotherapy induced febrile neutropenia predisposes patients to life threatening infections. We aimed to determine the causative microorganisms, infection focus and antibiotic treatment success in febrile neutropenic children with leukemia. A total of 136 febrile neutropenic episodes in 48 leukemic children were reviewed retrospectively from records. Among 136 febrile neutropenic episodes, 68 (50%) episodes were microbiologically documented. Methicillin sensitive coagulase (-) Staphylococcus aureus were the most common isolates from hemoculture (20.5%). The most frequently documented infection focus was mucositis (31.9%). Ceftazidime plus amikacin was the most commonly used antimicrobial treatment for the empirical therapy (52.9%). The overall response rates were 70.5%, 86.9%, and 66.6% of first line, second line and third line therapies, respectively.The spectrum of isolates among febrile neutropenic children in our hematology clinic appears to be gram positive pathogens which are the most common agents. Therefore the, documentation of the flora in each unit could help to decide appropriate empirical therapy which is life saving

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  • 1. Hurtado IC, Sánchez DP, Espinal DA, Garcés C. Clinical and laboratory evolution of the febrile neutropenia episodes in pediatric patients hospitalized in a Colombian hospital in 2007-2009. Rev Chilena Infectol 2012; 29: 672-676.
  • 2. Paul M, Yahav D, Fraser A, Leibovici L. Empirical antibiotic monotherapy for febrile neutropenia: systematic review and meta-analysis of randomized controlled trials. J Antimicrob Chemother 2006; 57: 176-189.
  • 3. Laoprasopwattana K, Pruekprasert P, Laosombat V, Wongchanchailert M. Clinical outcome of febrile neutropenia in children with cancer using ceftazidime and aminoglycosides. Pediatric Hematol Oncol 2007; 24: 595-606.
  • 4. Zinner SH. Changing epidemiology of infections in patients with neutropenia and cancer: emphasis on gram-positive and resistant bacteria. Clin Infect Dis 1999; 29: 490-494.
  • 5. Hann I, Viscoli C, Paesmans M, Gaya H, Glauser M. A comparison of outcome from febrile neutropenic episodes in children compared with adults: results from four EORTC studies. International Antimicrobial Therapy Cooperative Grout (IATCG) of the European Organization for Research and Treatment for Cancer (EORTC). Br J Haematol 1997; 99: 580-588.
  • 6. Gabay M, Tanzı M. Guidelines for the Managament of Febrile Neutropenia. Clinical Oncology News Special Edition 2010; 1: 115-122.
  • 7. Jin J, Lee YM, Ding Y, et al. Prospective audit of febril neutropenia management at a Tertiary University hospital in Singapore. Ann Acad Med Singapore 2010; 39: 453-459.
  • 8. Paul M, Gafter-Gvili A, Leibovici L, et al. The epidemiology of bacteremia with febrile neutropenia: experience from a single center, 1988-2004. Isr Med Assoc J 2007; 9: 424-429.
  • 9. Klaassen IL, de Haas V, van Wijk JA, Kaspers GJ, Bijlsma M, Bökenkamp A. Pyuria is absent during urinary tract infections in neutropenic patients. Pediatr Blood Cancer 2011; 56: 868-870.
  • 10. Hakim H, Flynn PM, Knapp KM, Srivastava DK, Gaur A. Etiology and Clinical Course of Febrile Neutropenia in Children with Cancer. Pediatr Hematol Oncol 2009; 31: 623-629.
  • 11. Güneş D, Mutafoğlu K, Çetinkaya H, Arslan H, Çakır D, Olgun N. Febrile neutropenic episodes in children with lymphoma and malignant solid tumors. J Pediatr Inf 2010; 4: 1-8.
  • 12. Viscoli C, Varnier O, Machetti M. Infections in patients with febrile neutropenia: epidemiology, microbiology, and risk stratification. Clin Infect Dis 2005; 40(Suppl 4): 240-245.
  • 13. Santolaya ME, Alvarez AM, Avilés CL, et al. Admission clinical and laboratory factors associated with death in children with cancer during a febrile neutropenic episode. Pediatr Infect Dis J 2007; 26: 794-798.
  • 14. Hamidi AA, Başaran S, Çağatay AA, et al. Organisms isolated from blood cultures, their antimicrobial susceptibilities and patient characteristics in patients with febrile neutropenia. Klimik Journal 2009; 22: 88-91.
  • 15. Akan ÖA. Microorganism isolated a from blood cultures of febrile neutropenic patients in İbn-i Sina Hospital. Turk J Haematol 2003; 20: 227-231.
  • 16. Sanboonrat P, Chainansamit S, Sriraska K. Febrile neutropenia in children with acute leukemia. Khon Kaen Med J 2009; 33: 2-8.
  • 17. Jeddi R, Achour M, Amor RB, et al. Factors associated with severe sepsis: prospective study of 94 neutropenic febrile episodes. Hematology 2010; 15: 28-32.
  • 18. Düzova A, Kutluk T, Kanra G, et al. Monotherapy with meropenem versus combination therapy with piperacilin plus amikacin as empiric therapy for neutropenic fever in children with lymphoma and solid tumors. Turk J Pediatr 2001; 43: 105-109.
  • 19. Kobayashi S, Ito M, Sano H, et al. Clinical analysis of combination therapy for febrile neutropenic patients in childhood cancer. Pediatr Int 2013; 55: 65–71.
  • 20. Paganini H, Bologna R, Debbeq R, et al. Fever and neutropenia in children with cancer in one pediatric hospital in Argentina. Pediatr Hematol Oncol 1998; 15: 405-413.
  • 21. Oguz A, Karadeniz C, Citak EC, Cil V. Eldes N. Experience with cefepime versus meropenem as empiric monotherapy for neutropenia and fever in pediatric patients with solid tumors. Pediatr Hematol Oncol 2006; 23: 245-253.
  • 22. Viscoli C, Van der Auwera P, Meunier F. Gram-positive infections in granulocytopenic patients: an important issue? J Antimicrob Chemother 1988;21( Suppl C): 149-156.
  • 23. Meckler C, Lindemulder S. Fever and neutropenia in pediatric patients with cancer. Emerg Med Clin N Am 2009; 27: 525-544.
  • 24. Aparicio J, Oltra A, Llorca C, et al. Randomised comparison of ceftazidime and imipenem as initial monotherapy for febrile episodes in neutropenic cancer patients. Eur J Cancer 1996; 32: 1739-1743.
  • 25. Fleischhack G, Harttmann C, Simon A, et al. Mreopenem versus ceftazidime as empirical monotherapy in febril neutropenia of paediatric patients with cancer. J Antimicrob Chemother 2001; 47: 841-853.
  • 26. Cometta A, Calandra T, Gaya H. et al. Monotherapy with meropenem versus combination therapy with ceftazidime plus amikacin as empiric therapy for fever in granulocytopenic patients with cancer. The International Antimicrobial Therapy Cooperative Group of the European Organization for Research and Treatment of Cancer and the Gruppo Italiono Malattie Ematologiche Maligne dell’Adulto Infection Program. Antimicrob Agents Chemother 1996; 40: 1108-1115.
  • 27. Lai HP, Hsueh PR, Chen YC, et al. Bacteremia in hematological and oncological children with febrile neutropenia: experience in a tertiary medical center in Taiwan. J Microbiol Immunol Infect 2003; 36: 197-202.
  • 28. Paganini H, Gomez A, Ruvinsky S, et al. Outpatient, sequential, parenteral-oral antibiotic therapy for lower risk febrile neutropenia in children with malignant disease A single-center, randomized, controlled trial in Argentina. Cancer 2003; 97: 1775-1780.
  • 29. Hautala T, Ikaheimo I, Husu H. et al. A cluster of Candida krusei infections in a haematological unit. BMC Infectious Diseases 2007; 97: 1-8.
  • 30. Fleischhack G, Schmidt-Niemann M, Wulff B, et al. Piperacillin, beta-lactam inhibitor plus gentamicin as empirical therapy of a sequential regimen in febrile neutropenia of pediatric cancer patients. Support Care Cancer 2001; 9: 72-79.
  • 31. Ariffin H, Arasu A, Mahfuzah M, Ariffin WA, Chan LL, Lin HP. Single-daily ceftriaxone plus amikacin versus thrice-daily ceftazidime plus amikacin as empirical treatment of febrile neutropenia in children with cancer. J Paediatr Child Health 2001; 37: 38-43.
Turkish Journal of Pediatrics-Cover
  • ISSN: 0041-4301
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 1958
  • Yayıncı: Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü
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