Bacteremia in childhood cancer
Bacteremia in childhood cancer
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DOI：
10.1093/tropej/48.6.373
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发表时间：
2002-12-01
影响因子：
2
通讯作者：
Yildiz, I
中科院分区：
文献类型：
--
作者：
Celkan, T;Ozkan, A;Yildiz, I
与预防有关的死亡率影响到接受癌症治疗的儿童的总体存活率。在发热性贫血患者中，死亡的主要原因是与之相关的菌血症和脓毒症。回顾了1995年1月至2001年1月期间在Cerrahpasa医学院儿科血液肿瘤学系治疗的所有发热性血小板减少症患者的阳性血培养。培养物中生长了159种微生物，其中95种（60%）为革兰氏阳性菌，56种（35%）为革兰氏阴性菌，8种（5%）为真菌。凝固酶阴性葡萄球菌（63，40%）和S。金黄色葡萄球菌（8.5%）是最常见的革兰氏阳性病原体。克雷伯氏菌属（Klebsiella）、E.革兰阴性菌以大肠杆菌、肠杆菌和假单胞菌感染为主。20例病例因败血症而丢失：11例（55%）为革兰氏阴性菌，8例（40%）为革兰氏阳性菌，仅1例为真菌。虽然万古霉素未被纳入一线治疗，但革兰阳性菌血症的死亡率为8%，革兰阴性菌血症的死亡率为20%，革兰阴性菌对多种抗生素耐药是导致死亡的主要原因。在制定发热性中性粒细胞减少症方案时，必须考虑微生物引起的耐药性和死亡率。
Infection-related mortality affects the overall survival rates of children who are receiving treatment for cancer. The leading cause of mortality is bacteremia and sepsis related to it in febrile neutropenic patients. All positive blood cultures of febrile neutropenic patients treated in the Department of Pediatric Hematology-Oncology, Cerrahpasa Medical School, between January 1995 and January 2001 were reviewed. Cultures grew 159 micro-organisms, 95 (60 per cent) of which were Gram-positive bacteria, 56 (35 per cent) were Gram-negative bacteria and eight (5 per cent) were fungi. Coagulase-negative staphylococci (63, 40 per cent) and S. aureus (8, 5 per cent) were the most frequent Gram-positive pathogens. Klebsiella, E. coli, Enterobacter and Pseudomonas infections were the primary Gram-negative pathogens. Twenty cases were lost because of sepsis: in 11 cases (55 per cent) Gram-negative bacteria, in eight cases (40 per cent) Gram-positive bacteria, and in only one case a fungus were the causative organisms. Although vancomycin was not included in the first-line treatment, the mortality rate of Gram-positive bacteremia was 8 per cent. In Gram-negative bacteremia it was 20 per cent. Gram-negative pathogens, which were resistant to multiple antibiotics, caused the mortality. Drug resistance and mortality due to micro-organisms must be taken into consideration while febrile neutropenia protocols are prepared.