BACKGROUND: Pandemic influenza A (hereafter 2009/H1N1) caused significant morbidity and mortality during the 2009 pandemia. Patients with chronic medical conditions and immunosuppressive diseases had a greater risk of complications. However, data regarding the characteristics and outcome of 2009/H1N1 infection in patients with solid tumors are nonexistent. Herein, the authors describe a series of influenza 2009/H1N1 in patients with solid malignancies at 3 major cancer hospitals worldwide. METHODS: The authors retrospectively reviewed the records of patients with solid organ malignancies and 2009/H1N1 from The University of Texas M. D. Anderson Cancer Center in Houston, Texas; the Mexican National Cancer Institute, Federal District of Mexico; and King Hussein Cancer Center in Amman, Jordan from the period of the 2009 H1N1 pandemia. Data on demographics, disease characteristics, and outcome were extracted. RESULTS: In total, 115 cases were identified during the pandemic influenza among the 3 institutions. High rates of hospitalization (50%), pneumonia (23%), and death (9.5%) were reported. Patients who developed pneumonia and those who died were moderately to severely immunocompromised (P = .001 and P = .006, respectively). A multivariate competing risk analysis demonstrated that a delay >48 hours in starting antiviral therapy was associated significantly with an increased risk of developing pneumonia (P = .013). CONCLUSIONS: The 2009/H1N1 pandemic caused severe illness in immunocompromised patients with cancer who had solid tumors, and heavily immunosuppressed patients were at greater risk of developing pneumonia and death. Early initiation of antiviral therapy is crucial in this patient population to decrease morbidity and probably mortality. Cancer 2012. © 2012 American Cancer Society.

AB infections in critically ill cancer patients were independently associated with increased mortality and increased ICU LOS. Measures to improve the outcomes of critically ill cancer patients infected with AB are necessary.

In hematology/oncology patients, influenza was as severe in the post-pandemic as in the pandemic season. Pneumonia developed more commonly in patients infected with pH1N1 virus. Healthcare acquisition of infection and low albumin were associated with the development of pneumonia. Delayed initiation of antiviral treatment was associated with both pneumonia and mortality.

Higher than usual vancomycin doses may be required to treat serious MRSA infections in pediatric patients. The currently recommended dose of 60 mg/kg/day is unlikely to achieve the targets in most subjects. The optimal vancomycin dosing in pediatric cancer patients requires further investigations.

BackgroundUrinary tract infections (UTIs) may present with nonspecific symptoms and without any definitive clinical signs other than fever, hence may be missed without a routine urine analysis. We retrospectively evaluated all cases of culture-positive urine infections in pediatric oncology patients in our center during the year 2015.MethodsWe assessed all positive urine culture incidents for pediatric patients receiving treatment and/or follow-up at our center during 2015. Analysis was performed on patients with regards to clinical, microbiology and pertinent lab findings as well as associated risk factors.ResultsThere were 151 episodes of documented positive urine cultures among 73 patients. Majority of positive urine cultures were found in solid tumor patients (41%), followed by hematological malignancies (26%). Most organisms detected were gram-negative organisms (84%), with E.coli being the most frequent (51%). Forty percent of bacteria were resistant to standard broad-spectrum antibiotics, with the majority being extended-spectrum beta-lactamase-producing. Most of these infections occurred in patients receiving prophylactic antibiotics (46 out of 50). Approximately two thirds of patients were not febrile on the day of culture (64%) and almost half of the reported episodes were associated with urinary symptoms. Pyuria, leukocyte esterase and nitrites were positive in 39%, 51% and 19% of samples, respectively.ConclusionsPositive urine culture in children with cancer may not be associated with urinalysis abnormalities, particularly in patients with neutropenia. When selecting empiric treatment for cancer patients with UTIs, one should take into consideration the institutional patterns for resistance and use of prophylactic antibiotics.