Viridans streptococci bacteraemia in children with fever and neutropenia: a case–control study of predisposing factors

Viridans streptococci (VS) are an increasing cause of bacteraemia in neutropenic patients with cancer. Case–control studies of predisposing factors for acquisition of this infection in children are not published. Between January 1989 and December 1999, 168 episodes of bacteraemia in 161 children wit...

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Bibliographic Details
Published in:European journal of cancer (1990) 2003-06, Vol.39 (9), p.1284-1289
Main Authors: Paganini, H., Staffolani, V, Zubizarreta, P., Casimir, L., Lopardo, H., Luppino, V.
Format: Article
Language:English
Subjects:
Adolescent
Antimetabolites, Antineoplastic - adverse effects
Bacteraemia
Bacteremia - etiology
Biological and medical sciences
Cancer
Case-Control Studies
Child
Child, Preschool
Children
Cytarabine - adverse effects
Drug toxicity and drugs side effects treatment
Female
Fever - chemically induced
Fever - microbiology
Humans
Infant
Male
Medical sciences
Multiple tumors. Solid tumors. Tumors in childhood (general aspects)
Multivariate Analysis
Neoplasms - complications
Neoplasms - drug therapy
Neutropenia - chemically induced
Neutropenia - microbiology
Pharmacology. Drug treatments
Predisposing factors
Retrospective Studies
Risk Factors
Streptococcal Infections - chemically induced
Toxicity: blood
Tumors
Viridans Streptococci
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Summary:Viridans streptococci (VS) are an increasing cause of bacteraemia in neutropenic patients with cancer. Case–control studies of predisposing factors for acquisition of this infection in children are not published. Between January 1989 and December 1999, 168 episodes of bacteraemia in 161 children with fever and neutropenia of haemato-oncology origin were analysed. 15 cases (9%) in 15 patients were caused by VS. Each case patient was compared with 6 matched control patients; 2 with other Gram-positive cocci (group 2), 2 with gram-negative bacilli bacteraemia (group 3) and two children with fever and neutropenia without bacteraemia (group 4). The median age of patients was 4.1 years (range: 2–15 years). 87% of children had acute leukaemia or lymphomas. Pneumonia was the predominant clinical focus (70%). Shock was observed in 13% of patients. ARDS was observed in one child who died of this complication. Multivariate analysis of risk factors for the development of VS bacteraemia showed that two factors were independent predictors: high doses of cytosine-arabinoside (ARA-C) as part of the chemotherapy treatment (Odds Ratio (OR): 9.3; Confidence Interval (CI) 1.56–55.5) (P
ISSN:0959-8049
1879-0852
DOI:10.1016/S0959-8049(03)00272-7