Incidence of septicaemias and invasive mycoses in children undergoing treatment for solid tumors: a 12 years experiences at a single Italian institution


Haupt, R; Romanengo, M; Fears, T; Viscoli, C; Castagnola, E; (2001) Incidence of septicaemias and invasive mycoses in children undergoing treatment for solid tumors: a 12 years experiences at a single Italian institution. European journal of cancer (Oxford, England, 37 (18). pp. 2413-9. ISSN 0959-8049 DOI: https://doi.org/10.1016/S0959-8049(01)00274-X

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Abstract

We carried out a retrospective study on the infection rate--in episodes per 100 person months at risk (p/m/r)--of septicaemia and invasive mycoses in children with solid tumours treated at a single institution between 1985 and 1996. Among 982 patients, accounting for 8108 p/m/r, 257 infectious episodes were documented, for an infection rate of 3.2. The infection rate for "intensive" treatment was greater than that for "less intensive" treatments, 3.7 compared with 0.5, respectively; P<0.001. 58% of infectious episodes were associated with neutropenia, 22% were megatherapy-related, and 39% were related to central venous catheter (CVC), while in 13% of the episodes no risk factor was identified. Of the episodes, single organism Gram-positive bacteraemias accounted for 62%, single organism Gram-negative for 23%, multiple organism bacteraemias for 7%, invasive mycoses for 4%, and isolated fungaemias for 4%. The infection rate for Gram-positive organisms decreased significantly over time (-5.9% per year; P<0.01), but increased for the Gram-negative organisms (+3.4% per year; P=0.4). This study demonstrates that the risk of bacteraemia increases in parallel with the treatment intensity, and that a considerable number of children with solid tumours develop bacteraemia in the absence of an identifiable risk factor.

Item Type: Article
Keywords: Adolescence, Bacteremia, epidemiology, Catheterization, Central Venous, Child, Child, Preschool, Equipment Contamination, prevention & control, Fungemia, epidemiology, Human, Incidence, Infant, Infant, Newborn, Italy, epidemiology, Neoplasms, microbiology, therapy, Quality of Health Care, Regression Analysis, Retrospective Studies, Risk Factors
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
PubMed ID: 11720836
Web of Science ID: 172631200022
URI: http://researchonline.lshtm.ac.uk/id/eprint/18271

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