Prospective Evaluation of a Model of Prediction of Invasive Bacterial Infection Risk among Children with Cancer, Fever, and Neutropenia

Abstract

A risk prediction model for invasive bacterial infection (IBI) was prospectively evaluated among children presenting with cancer, fever, and neutropenia. The model incorporated assessment of 5 previously identified risk factors: serum level of C-reactive protein (CRP) >/=90 mg/L, hypotension, identification of relapse of leukemia as the cancer type, platelet count of </=50,000 platelets/mm(3), and recent receipt of chemotherapy [16]. Children were uniformly evaluated at enrollment and were classified as having high or low risk for IBI according to a model that considers the number and type of variables present. Of the 263 febrile episodes evaluated during a 17-month period, 140 (53%) were in IBI-positive children. The sensitivity, specificity, and positive and negative predictive values of the model were 92%, 76%, 82%, and 90%, respectively. Identification of these 5 risk factors during the first 24 h of hospitalization was helpful in discriminating between children with a high or low risk for IBI.

Infections during high dose methotrexate therapy in childhood acute lymphoblastic leukemia (ALL)

“…Study done by Santolaya M et al showed the mean age was 7±4 years. 29 Among the study group 64% cases were male; indicating male preponderance and among them 31[62%] were younger than 5 year; similar to the study done by Jacques N and Judith MC.…”

Surveillance with successful reduction of central line-associated bloodstream infections among neutropenic patients with hematologic or oncologic malignancies

“…The duration of neutropenic phases caused by chemotherapy represents an important risk factor for acquiring nosocomial infections independently of undergoing a HSCT [25][26][27]. In our study we demonstrated that the main significant risk factors for nosocomial CA-BSI acquired during neutropenia are transplantation and the diagnosis and treatment for an AML.…”

Composite Adverse Event Outcome in Pediatric Cancer Patients with Prolonged Febrile Neutropenia

“…[11,15,16] A recently published study reported 11.1% composite AE outcome in FN patients with in-hospital mortality of (0.7%), PICU admission (4.7%), and fluid resuscitation > 40 ml/kg in (10.1%). [17] Out data also showed that severe myelosuppression was associated with composite AE outcome as patients with more severe neutropenia and thrombocytopenia have a higher risk for AE [13,21].…”