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

Melissa Beauchemin, Alison F. Marshall, Angela M. Ricci, Ibis D. Lopez, Yujing Yao, Alice Lee, Zhezhen Jin, Maria L. Sulis

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)E194-E198
JournalJournal of Pediatric Hematology/Oncology
Volume44
Issue number1
DOIs
StatePublished - Jan 1 2022
Externally publishedYes

Keywords

  • Bacteremia
  • Fever
  • Non-neutropenia
  • Pediatric oncology

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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