Bloodstream infections and inpatient length of stay among pediatric cancer patients with febrile neutropenia in Mexico City

Avilés-Robles, Martha; Ojha, Rohit P.; González, Miriam; Ojeda-Diezbarroso, Karla; Dorantes-Acosta, Elisa; Jackson, Bradford E.; Johnson, Kyle M.; Caniza, Miguela

doi:10.1016/j.ajic.2014.07.021

Cited by 15 publications

(23 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, malnourishment is associated with hospital-acquired infections among paediatric cancer patients,4 which also increases the length of stay 19. Such consequences underscore the importance of our finding that paediatric cancer patients with BMI equal to the age-specific and sex-specific mean BMI in the world reference population have the shortest length of stay.…”

Section: Discussionmentioning

confidence: 81%

See 1 more Smart Citation

Malnourishment and length of hospital stay among paediatric cancer patients with febrile neutropaenia: a developing country perspective

Conner

Avilés-Robles

Asdahl

et al. 2016

BMJ Support Palliat Care

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 81%

“…Our source population has been previously described 19. Briefly, Hospital Infantil de Mexico Federico Gomez in Mexico City is a 248-bed public tertiary care centre for children aged <18 years, which includes a 32-bed paediatric haematology and oncology unit.…”

Section: Methodsmentioning

confidence: 99%

Malnourishment and length of hospital stay among paediatric cancer patients with febrile neutropaenia: a developing country perspective

Conner

Avilés-Robles

Asdahl

et al. 2016

BMJ Support Palliat Care

Self Cite

View full text Add to dashboard Cite

show abstract

“…Overall, little information is available regarding the outcomes of patients experiencing FN episodes in Mexico 20‐22 . However, it has been reported that FN episodes with confirmed bacteremia, as well as the presence of malnutrition, can double the length of hospital stay 23,24 …”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of step‐down to oral outpatient treatment versus inpatient antimicrobial treatment in pediatric cancer patients with febrile neutropenia: A noninferiority multicenter randomized clinical trial

Avilés-Robles

Reyes‐López

Otero-Mendoza

et al. 2020

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Background It has been suggested that low‐risk febrile neutropenia (FN) episodes can be treated in a step‐down manner in the outpatient setting. This recommendation has been limited to implementation in middle‐income countries due to concerns about infrastructure and lack of trained personnel. We aimed to determine whether early step‐down to oral antimicrobial outpatient treatment is not inferior in safety and efficacy to inpatient intravenous treatment in children with low‐risk FN. Procedure A noninferiority randomized controlled clinical trial was conducted in three hospitals in Mexico City. Low‐risk FN was identified in children younger than 18 years. After 48 to 72 hours of intravenous treatment, children were randomly allocated to receive outpatient oral treatment (experimental arm, cefixime) or to continue inpatient treatment (standard of care, cefepime). Daily monitoring was performed until neutropenia resolution. The presence of any unfavorable clinical outcome was the endpoint of interest. We performed a noninferiority test for comparison of proportions. Results We identified 1237 FN episodes; 117 cases were randomized: 60 to the outpatient group and 57 for continued inpatient treatment. Of the FN episodes, 100% in the outpatient group and 93% in the inpatient group had a favorable outcome (P < 0.001). The mean duration of antibiotics was 4.1 days (SD 2.5; 95% CI, 3.4‐4.8 days) in the outpatient group and 4.4 days (SD 2.5; 95% CI, 3.7‐5.0 days) in the inpatient group (P = 0.70). Conclusions In our population, step‐down oral outpatient treatment of low‐risk FN was as safe and effective as inpatient intravenous treatment. Clinical Trials Identifier: NCT04000711.

show abstract

“…4,40 In Addition, Avilés-Robles et al found that patients with sepsis had a long FN duration than those without sepsis (95%CI 1.6 to 2.6 ). 41 The shortcoming of this study was the retrospective design, which relied heavily on the accuracy of medical records for socioeconomic status data. Further research is needed to analyze the role of antioxidants (selenium and tocopherol) on the occurrence of FN and improvement of nutritional status.…”

Section: Discussionmentioning

confidence: 99%

Impact of malnutrition on febrile neutropenia in children with acute lymphoblastic leukemia during induction phase chemotherapy

Agnes

Widjajanto

Damayanti

2018

View full text Add to dashboard Cite

Background Acute lymphoblastic leukemia (ALL) is the most common malignancy in children and adolescents. Febrile Neutropenia (FN) is a medical emergency on ALL that often leads to death. Nutrition status assessment on ALL patient is important because malnutrition can reduce the tolerance of chemotherapy, increase incidence of infection and decrease survival rate. Objectives To assess malnutrition as a risk factor for FN in children with ALL. Methods This case-control study was performed at Sardjito Hospital, Yogyakarta on patients aged 1 month to 18 years diagnosed with ALL and undergoing induction phase chemotherapy between January 2013 and December 2015. The case and control subjects were children with and without FN, respectively. Febrile neutropenia was confirmed by patients temperature above 38ºC at one measurement and a peripheral neutrophil count of less than 1,000/mm3. Malnutrition was defined as body weight-for-height was between -2 and <-3 standard deviation. Subjects were included using simple random sampling. Result Bivariate analysis showed a significant correlation between malnutrition and FN (OR 2.62; 95%CI 1.07 to 6.45; P=0.03). However, there was no inverse correlation between socioeconomic status and FN (OR 1.1; 95%CI 0.42 to 2.41; P=0.83). There was no correlation between nutritional status and duration of FN (P= 0.48). Conclusion Malnutrition is a risk factor for FN in children with acute lymphoblastic leukemia.

show abstract

Bloodstream infections and inpatient length of stay among pediatric cancer patients with febrile neutropenia in Mexico City

Cited by 15 publications

References 13 publications

Malnourishment and length of hospital stay among paediatric cancer patients with febrile neutropaenia: a developing country perspective

Malnourishment and length of hospital stay among paediatric cancer patients with febrile neutropaenia: a developing country perspective

Safety and efficacy of step‐down to oral outpatient treatment versus inpatient antimicrobial treatment in pediatric cancer patients with febrile neutropenia: A noninferiority multicenter randomized clinical trial

Impact of malnutrition on febrile neutropenia in children with acute lymphoblastic leukemia during induction phase chemotherapy

Contact Info

Product

Resources

About