Risk factors for bacteremia in children with febrile neutropenia

Area of Science:

• Pediatric Hematology Oncology
• Infectious Diseases
• Clinical Microbiology

Background:

• Febrile neutropenia (FN) is a common complication in pediatric cancer patients.
• Bacteremia significantly contributes to morbidity and mortality during FN episodes.
• Identifying risk factors for bacteremia is crucial for timely intervention.

Purpose of the Study:

• To determine the risk factors associated with bacteremia in children with hematological malignancies experiencing FN.
• To identify specific clinical and microbiological predictors of bacteremia in this vulnerable population.

Main Methods:

• Retrospective analysis of 150 pediatric patients (≤18 years) with FN.
• Comparison of patients with bacteremia versus those with negative blood cultures.
• Evaluation of demographic, clinical, and microbiological data.

Main Results:

• Bacteremia was identified in 23.3% of patients, with Coagulase-negative staphylococci being the most common pathogen.
• Key risk factors identified include leukopenia, severe neutropenia, central line presence, prior FN episodes, and positive cultures from central lines within 3 months.
• Previous FN episodes and positive central line cultures within 3 months increased bacteremia risk by 2.5-fold and 2.4-fold, respectively.

Conclusions:

• Previous febrile neutropenia episodes and positive central line cultures within the prior 3 months are significant predictors of bacteremia in pediatric oncology patients.
• These identified risk factors can aid in the early prediction and management of bacteremia in children with FN.