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Current concepts of bacteremia in children with malignancies
Author(s) -
Hoecker Jay L.,
Pickering Larry K.,
Kohl S.,
Groschel D.,
van Eys J.
Publication year - 1979
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197911)44:5<1939::aid-cncr2820440557>3.0.co;2-l
Subject(s) - bacteremia , medicine , antibiotics , meningitis , streptococcus pneumoniae , leukemia , pediatrics , microbiology and biotechnology , biology
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 < .025) number of chldren 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 < .05) greater number of children with lymphoma died when compared to children with other malignancies. Absolute polymorphonuclear leukocyte counts were greater in survivors (p < .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 < .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.