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Observational Study
. 2022 Jan 1;44(1):e194-e198.
doi: 10.1097/MPH.0000000000002201.

Bacteremia in Febrile, Non-neutropenic, and Well-appearing Children With Cancer

Melissa Beauchemin  1   2 , Alison F Marshall  3 , Angela M Ricci  4 , Ibis D Lopez  1 , Yujing Yao  5 , Alice Lee  1 , Zhezhen Jin  5 , Maria L Sulis  6
Affiliations
Observational Study

Bacteremia in Febrile, Non-neutropenic, and Well-appearing Children With Cancer

Melissa Beauchemin et al. J Pediatr Hematol Oncol. .

Abstract

Fever in a neutropenic pediatric oncology patient requires prompt assessment due to the risk of infectious complications. The appropriate management of fever in non-neutropenic patients, however, is not well-established. We describe the rate of bacteremia in a cohort of non-neutropenic pediatric oncology patients with fever at a large institution. Patients were included if they presented to the emergency department or outpatient clinic between 2009 and 2014 with fever, had a central venous catheter (CVC), and were not neutropenic. Three hundred eighty-six episodes of fever occurring in 159 patients were included in the data analysis. Fifty-nine percent of patients were male, 41% had a diagnosis of acute lymphoblastic leukemia, and 90% had a port-a-cath as CVC. The rate of bacteremia was 3.4%; presence of a port-a-cath was protective against bacteremia whereas a white blood cell count >20,000/mm3 was associated with a higher likelihood of bacteremia. Gram-positive microorganisms were most commonly isolated (64.3%) and frequently resistant to cephalosporins. In summary, in our study, the rate of bacteremia was low among non-neutropenic, well-appearing pediatric cancer patients with a CVC and was not associated with any serious medical complications. Prospective research is needed to determine the most appropriate management of these patients.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1:
Figure 1:
STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) Diagram for Study Cohort
See this image and copyright information in PMC

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