Etiologi Demam Neutropenia pada Anak dengan Keganasan dan Penggunaan Skor Klasifikasi Rondinelli

Adrieanta, Adrieanta; Windiastuti, Endang; Handryastuti, Setyo

doi:10.14238/sp16.4.2014.229-35

Cited by 3 publications

(13 citation statements)

References 6 publications

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“…This study were similar to previous studies that pediatric ALL patients with febrile neutropenia were predominantly male. 1,7,8,9 Most patients aged over fi ve years, as many as 17 people (56.7%) in line with the previous study that patients aged above 5 years more in number than under 5 years, 1,8 but the proportion is almost the same. 7 This study is similar to the previous studies in that patient's hemoglobin level was predominantly above 7 IJTID, p-ISSN 2085-1103, e-ISSN 2356-0991 Open access under CC-BY-NC-SA Share alike 4.0 g/dL.…”

Section: Resultssupporting

confidence: 88%

“…Febrile neutropenia (FN) is when axillary temperature >38 o C persists for more than two hours or axillary temperature >39 o C on one measurement with neutrophils <1000 cells/ microliter. 1 Febrile neutropenia is the most severe complication that accounts for 50%-70% of deaths in patients with hematological malignancies and chemotherapy. 2 Acute lymphoblastic leukemia is the most common type of acute leukemia in children.…”

Section: Introductionmentioning

confidence: 99%

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Correlation Between Risk of Febrile Neutropenia Based on Rondinelli Score with Clinical Outcomes in Acute Lymphoblastic Leukemia Patients

Alifadiningrat

Puspitasari²,

Hernaningsih³

2022

IJTID

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Febrile neutropenia (FN) is the most severe complication in patients with blood cancer and chemotherapy. Acute lymphoblastic leukemia (ALL) is the most common type of cancer in children and the most common cause of febrile neutropenia. The low number of neutrophils in ALL patients due to lymphoblast cancer cells and the toxicity of chemotherapy makes patients susceptible to infection which, if not treated immediately, can lead to death. Early risk assessment for infectious complications in FN patients is needed to increase clinician awareness in high-risk patients and eliminate unnecessary therapy for low-risk patients. The Rondinelli scoring system is a reasonably good instrument for predicting severe infectious complications in pediatric patients with ALL who have febrile neutropenia. This study aims to determine the relationship between the risk category for febrile neutropenia (FN) based on the Rondinelli score with clinical outcomes in FN patients with acute lymphoblastic leukemia (ALL) in the Hematology-Oncology division of the child health department of RSUD Dr. Soetomo. This analytic observational study used secondary data FN patients with acute lymphoblastic leukemia (ALL) implementing a total sampling. From 30 samples of pediatric ALL patients with febrile neutropenia at Dr. Soetomo Hospital for June 2018-June 2020 it was found 17 patients (56.7%) had a moderate risk score category, and 13 others were in a low-risk category (43.3 %). Patients were dominated by moderate and severe severity of neutropenia respectively, 43.3%, had neutropenia for 1-7 days (50%), fever less than seven days (66.7%), had a length of stay of 8-14 days, and 15-30 days 33.3% each. Conclusion from this research is that there was a signiﬁ cant relationship between the Rondinelli score category in pediatric ALL patients with FN with the severity of neutropenia p=0.037; R=0.383), duration of neutropenia (p=0.021; R=0.420), duration of fever (p=0.000; R=0.618), and length of stay (p-value 0.005; R=0.496).

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Section: Resultssupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Correlation Between Risk of Febrile Neutropenia Based on Rondinelli Score with Clinical Outcomes in Acute Lymphoblastic Leukemia Patients

Alifadiningrat

Puspitasari²,

Hernaningsih³

2022

IJTID

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“…Selama beberapa dekade terakhir terdapat perubahan global berupa predominasi organisme Gram positif disebabkan penggunaan antibiotik profilaksis, kondisi lingkungan lokal, dan kateter intravena lama. 1,5,8,7 Hal tersebut juga serupa dengan yang didapatkan pada penelitian ini. Fungi, terutama Candida sp, lebih sering ditemukan setelah pemberian antibiotik spektrum luas jangka panjang, tetapi terkadang dapat merupakan infeksi patogen primer.…”

Section: Pembahasanunclassified

“…1 Peningkatan penggunaan profilaksis antifungal dapat menyebabkan perubahan distribusi isolat fungi. 8 …”

Section: Pembahasanunclassified

Kejadian Demam Neutropenia pada Anak dengan Keganasan

Nursyirwan

Windiastuti²

2018

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Latar belakang. Demam merupakan salah satu manifestasi awal dari infeksi berat, terutama selama periode neutropenia. Infeksi menjadi penyebab utama morbiditas dan mortalitas pada pasien kanker. Data mikroorganisme tersering beserta sensitivitasnya dapat memberikan pola dan menjadi petunjuk tata laksana pasien anak dengan demam neutropenia. Tujuan. Mengetahui kejadian demam neutropenia pada pasien anak dengan keganasan. Metode. Penelitian potong lintang retrospektif dilakukan pada 65 pasien usia 0-18 tahun dengan penyakit keganasan yang dirawat di Departemen Kesehatan Anak, RSCM Jakarta dalam kurun waktu satu tahun sejak 1 April 2015 sampai dengan 30 April 2016. Diagnosis keganasan ditegakkan berdasarkan aspirasi sumsum tulang atau biopsi tumor. Dilakukan pengumpulan dan analisis data kejadian demam neutropenia, kejadian infeksi, serta pola sensitivitas antibiotik dari isolat patogen. Hasil. Keganasan darah (LLA dan LMA) lebih sering ditemukan daripada tumor padat. Dalam satu tahun terjadi 83 episode rawat karena demam neutropenia. Bakteremia tersering disebabkan oleh bakteri Gram positif (6,4%) dibandingkan Gram negatif (5,7%). Hasil kultur dari sampel darah, urin, tinja, sputum, dan apusan luka tersering adalah steril (55,2%). Luaran pasien demam neutropenia yang meninggal tersering didapatkan pada pasien LMA (18,8%), LLA (17,2%), rabdomiosarkoma (12,5%), limfoma maligna non Hodgkin (LMNH) (10%), diikuti tumor padat lainnya. Sensitivitas antibiotik tertinggi didapatkan pada vankomisin. Incidence of Febrile Neutropenia in Pediatric Patients with Malignancies Sarah Rafika Nursyirwan, Endang WindiastutiBackgrounds. Fever is one of the early manifestations of severe infections, especially during periods of neutropenia. Infection is a major cause of morbidity and mortality in malignancy. Data on microorganisms and their sensitivity could provide patterns and clues to manage patients with febrile neutropenia. Objectives. To report the incidence of febrile neutropenia in pediatric patients with malignancies. Methods. A cross-sectional retrospective study was performed on 65 patients aged 0 to 18 years with malignancies who were treated at the Department of Child Health, RSCM Jakarta within a period of 1 year from April 2015 to April 2016. The diagnosis of malignancy was confirmed by bone marrow aspiration or tumor biopsy. Data on the incidence of febrile neutropenia, the incidence of infection, and antibiotics sensitivity patterns of the pathogen was collected and analyzed. Results. Febrile neutropenia was more common in patients with hematologic malignancies (ALL and AML) than solid tumors. Within 1 year, there were 83 episodes of febrile neutropenia. Bacteremia was caused by Gram-positive bacteria (6.4%) more than Gramnegative bacteria (5.7%). Culture results from samples of blood, urine, feces, sputum, swabs were mainly sterile (55.2%). Patients who died with febrile neutropenia were commonly seen on AML (18.8%), ALL (17.2%), rhabdomyosarcoma (12.5%), non-Hodgkin lymphoma (10%), followed by other solid tumors. The...

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“…13 Other study carried out in Dr. Cipto Mangunkusumo Hospital in past years also found that bacteremia ranged from 12 to 17%. 14 The microorganism frequency changes over time. Different results from blood culture can occur in different countries or even in different areas in the same country.…”

Section: Discussionmentioning

confidence: 99%

Microbiological profiles and prognostic factors of infection mortality in febrile neutropenic children with malignancy

Astria

Satari²,

Gunardi³

et al. 2021

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Background Post-chemotherapy febrile neutropenia results in high morbidity and mortality in children with malignancy. Many prognostic factors, such as microorganism patterns, as well as the use of antibiotics and antifungals can affect the outcomes. However, limited study is available in Indonesia. Objective To determine the microbial profiles, antibiotic sensitivity, and other factors that influence mortality from febrile neutropenia in pediatric malignancies with infections. Methods This retrospective cohort and descriptive study of 180 children with 252 episodes of neutropenic fever was done in Cipto Mangunkusumo Hospital, Jakarta, between 2015 and 2017. Medical history of possible predictive prognostic factors, including microorganism patterns and antibiotic sensitivity, were recorded. Prognostic factors were analyzed using multivariate logistic regression tests. Results The most common bacteria was Gram-negative (54.5%), while Candida sp. was the most common fungal infection (82.5%). Klebsiella sp. was mainly sensitive to amikacin (85.71%), while Pseudomonas aeruginosa was sensitive to ceftazidime (75%), as well as amikacin and gentamicin (100% sensitivity in combination). Staphylococcus sp. was mainly sensitive to amoxi-clav and ampi-sulbactam (76.9%). Almost all fungal groups were susceptible to fluconazole, ketoconazole, voriconazole (80-100%). Prognostic factors that increased mortality risk were central venous cannulation (RR 1.947; 95%CI 1.114 to 3.402), wasting (RR 1.176; 95%CI 1.044 to 1.325), severe wasting (RR 1.241; 95%CI 0.975 to 1.579), and hematologic malignancies (RR 0.87; 95%CI 0.788 to 0.976). Conclusion Central venous cannulation and wasting are significant prognostic factors of increased mortality in children with febrile neutropenia. Gram negative bacteria along with Candida sp. is the most common pathogen in such condition.

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Etiologi Demam Neutropenia pada Anak dengan Keganasan dan Penggunaan Skor Klasifikasi Rondinelli

Cited by 3 publications

References 6 publications

Correlation Between Risk of Febrile Neutropenia Based on Rondinelli Score with Clinical Outcomes in Acute Lymphoblastic Leukemia Patients

Correlation Between Risk of Febrile Neutropenia Based on Rondinelli Score with Clinical Outcomes in Acute Lymphoblastic Leukemia Patients

Kejadian Demam Neutropenia pada Anak dengan Keganasan

Microbiological profiles and prognostic factors of infection mortality in febrile neutropenic children with malignancy

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