Korean J Hematol 2007; 42(4):
Published online December 30, 2007
https://doi.org/10.5045/kjh.2007.42.4.343
© The Korean Society of Hematology
박혜원, 윤회수, 임호준, 김미나, 서종진, 문형남
울산대학교 의과대학 서울아산병원 소아과학교실, 진단검사의학교실
Background:
Bloodstream infection is one of the important causes of mortality, and morbidity in pediatric patients with hemato-oncologic disease. The purpose of this study was to identify the risk factors related to mortality in patients who suffered from a bloodstream infection.
Methods: We retrospectively reviewed and analyzed the medical records of 133 pediatric patients with hemato-oncologic diseases who had episodes of bloodstream infection documented at Asan Medical Center from June 2002 through May 2005.
Results: A total of 288 pathogens were isolated, and there were 17 episodes of polymicrobial infections. Among the episodes of bloodstream infection, 93.4% were caused by bacteria of which 60.1% were gram-positive bacteria, and 33.3% were gram-negative bacteria. Fungal infections accounted for 6.6% of the infections. The main pathogens included Staphylococcus epidermidis (31.3%), Pseudomonas aeruginosa (8.3%), and Klebsiella pneumoniae (7.3%). Gram-positive organisms were isolated more frequently than gram-negative organisms, and non-albicans Candida species were documented more frequently than C. albicans in our study. Infection related mortality was 8.3% (11 of 133 patients). The pulmonary infiltration on chest X-ray (CXR) (P=0.001), and a low absolute neutrophil count (≤500/ՌL) (P=0.017) at the time of blood culture were significantly associated with mortality. Gram-negative bacterial infection (especially with Stenotrophomonas maltophilia) and fungal infection often progressed to the septic shock or death.
Conclusion: This study revealed that the presence of pulmonary infiltration on a CXR, neutropenia (≤500/ՌL), and gram-negative bacterial infection might be important risk factors of mortality in pediatric patients with hemato-oncologic diseases necessitating more aggressive and vigilant supportive care.
Keywords Bloodstream infection, Childhood cancer, Risk factors, Mortality
Korean J Hematol 2007; 42(4): 343-352
Published online December 30, 2007 https://doi.org/10.5045/kjh.2007.42.4.343
Copyright © The Korean Society of Hematology.
박혜원, 윤회수, 임호준, 김미나, 서종진, 문형남
울산대학교 의과대학 서울아산병원 소아과학교실, 진단검사의학교실
Hye Won Park, Hoi Soo Youn, Ho Joon Im, Mi, Na Kim, Jong Jin Seo, Hyung Nam Moon
Departments of Pediatrics and, Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Background:
Bloodstream infection is one of the important causes of mortality, and morbidity in pediatric patients with hemato-oncologic disease. The purpose of this study was to identify the risk factors related to mortality in patients who suffered from a bloodstream infection.
Methods: We retrospectively reviewed and analyzed the medical records of 133 pediatric patients with hemato-oncologic diseases who had episodes of bloodstream infection documented at Asan Medical Center from June 2002 through May 2005.
Results: A total of 288 pathogens were isolated, and there were 17 episodes of polymicrobial infections. Among the episodes of bloodstream infection, 93.4% were caused by bacteria of which 60.1% were gram-positive bacteria, and 33.3% were gram-negative bacteria. Fungal infections accounted for 6.6% of the infections. The main pathogens included Staphylococcus epidermidis (31.3%), Pseudomonas aeruginosa (8.3%), and Klebsiella pneumoniae (7.3%). Gram-positive organisms were isolated more frequently than gram-negative organisms, and non-albicans Candida species were documented more frequently than C. albicans in our study. Infection related mortality was 8.3% (11 of 133 patients). The pulmonary infiltration on chest X-ray (CXR) (P=0.001), and a low absolute neutrophil count (≤500/ՌL) (P=0.017) at the time of blood culture were significantly associated with mortality. Gram-negative bacterial infection (especially with Stenotrophomonas maltophilia) and fungal infection often progressed to the septic shock or death.
Conclusion: This study revealed that the presence of pulmonary infiltration on a CXR, neutropenia (≤500/ՌL), and gram-negative bacterial infection might be important risk factors of mortality in pediatric patients with hemato-oncologic diseases necessitating more aggressive and vigilant supportive care.
Keywords: Bloodstream infection, Childhood cancer, Risk factors, Mortality
Igor Stoma, Igor Karpov, Natalia Milanovich, Anatoly Uss, and Igor Iskrov
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