Bloodstream infection in paediatric cancer centres—leukaemia and relapsed malignancies are independent risk factors
In a prospective multicentre study of bloodstream infection (BSI) from November 01, 2007 to July 31, 2010, seven paediatric cancer centres (PCC) from Germany and one from Switzerland included 770 paediatric cancer patients (58 % males; median age 8.3 years, interquartile range (IQR) 3.8–14.8 years)...
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| Veröffentlicht in: | European journal of pediatrics 2015-05, Vol.174 (5), p.675-686 |
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| creator | Ammann, R. A. Laws, H. J. Schrey, D. Ehlert, K. Moser, O. Dilloo, D. Bode, U. Wawer, A. Schrauder, A. Cario, G. Laengler, A. Graf, N. Furtwängler, R. Simon, A. |
| description | In a prospective multicentre study of bloodstream infection (BSI) from November 01, 2007 to July 31, 2010, seven paediatric cancer centres (PCC) from Germany and one from Switzerland included 770 paediatric cancer patients (58 % males; median age 8.3 years, interquartile range (IQR) 3.8–14.8 years) comprising 153,193 individual days of surveillance (in- and outpatient days during intensive treatment). Broviac catheters were used in 63 % of all patients and Ports in 20 %. One hundred forty-two patients (18 %; 95 % CI 16 to 21 %) experienced at least one BSI (179 BSIs in total; bacteraemia 70 %, bacterial sepsis 27 %, candidaemia 2 %). In 57 %, the BSI occurred in inpatients, in 79 % after conventional chemotherapy. Only 56 % of the patients showed neutropenia at BSI onset. Eventually, patients with acute lymphoblastic leukaemia (ALL) or acute myeloblastic leukaemia (AML), relapsed malignancy and patients with a Broviac faced an increased risk of BSI in the multivariate analysis. Relapsed malignancy (16 %) was an independent risk factor for all BSI and for Gram-positive BSI.
Conclusion
: This study confirms relapsed malignancy as an independent risk factor for BSIs in paediatric cancer patients. On a unit level, data on BSIs in this high-risk population derived from prospective surveillance are not only mandatory to decide on empiric antimicrobial treatment but also beneficial in planning and evaluating preventive bundles.
What is Known:
•
Paediatric cancer patients face an increased risk of nosocomial bloodstream infections
(
BSIs
).
•
In most cases
,
these BSIs are associated with the use of a long-term central venous catheter
(
Broviac
,
Port
),
severe and prolonged immunosuppression
(
e.g. neutropenia
)
and other chemotherapy-induced alterations of host defence mechanisms
(
e.g. mucositis
).
What is New:
•
This study is the first multicentre study confirming relapsed malignancy as an independent risk factor for BSIs in paediatric cancer patients
.
•
It describes the epidemiology of nosocomial BSI in paediatric cancer patients mainly outside the stem cell transplantation setting during conventional intensive therapy and argues for prospective surveillance programmes to target and evaluate preventive bundle interventions
. |
| doi_str_mv | 10.1007/s00431-015-2525-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1675168557</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3661219961</sourcerecordid><originalsourceid>FETCH-LOGICAL-c485t-a8e96750e84c787b2a99cdcf71f577766c6dc916cda1d9d9cd9078c2895bbe563</originalsourceid><addsrcrecordid>eNp1kc9qFTEUh4Mo9lp9ADcScNPNaM7M5N9Si7WFgpt2Hc5NzpS0M5kxmVm48yF8Qp_EXG4VEdwkgfP9vhP4MfYaxDsQQr8vQvQdNAJk08pWNvIJ20HftQ0IrZ6yneh60Siw9oS9KOVe1IwF85ydtNKIHmy7Y9vHcZ5DWTPhxGMayK9xTvXFF6QQcc3Rc4_JU-aeUuXKz-8_RtoekKaIHFPgmUZcCgU-4RjvUoUjFY6ZqibQQvVIK8-xPPAB_Trn8pI9G3As9OrxPmW3F59uzi-b6y-fr84_XDe-N3Jt0JBVWgoyvddG71u01gc_aBik1lopr4K3oHxACDbUmRXa-NZYud-TVN0pOzt6lzx_3aisborF0zhionkrDqodlJFSV_TtP-j9vOVUf3egegXCyK5ScKR8nkvJNLglxwnzNwfCHTpxx05c7cQdOnGyZt48mrf9ROFP4ncJFWiPQKmjdEf5r9X_tf4Ciu2ZmA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1674610853</pqid></control><display><type>article</type><title>Bloodstream infection in paediatric cancer centres—leukaemia and relapsed malignancies are independent risk factors</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Ammann, R. A. ; Laws, H. J. ; Schrey, D. ; Ehlert, K. ; Moser, O. ; Dilloo, D. ; Bode, U. ; Wawer, A. ; Schrauder, A. ; Cario, G. ; Laengler, A. ; Graf, N. ; Furtwängler, R. ; Simon, A.</creator><creatorcontrib>Ammann, R. A. ; Laws, H. J. ; Schrey, D. ; Ehlert, K. ; Moser, O. ; Dilloo, D. ; Bode, U. ; Wawer, A. ; Schrauder, A. ; Cario, G. ; Laengler, A. ; Graf, N. ; Furtwängler, R. ; Simon, A.</creatorcontrib><description>In a prospective multicentre study of bloodstream infection (BSI) from November 01, 2007 to July 31, 2010, seven paediatric cancer centres (PCC) from Germany and one from Switzerland included 770 paediatric cancer patients (58 % males; median age 8.3 years, interquartile range (IQR) 3.8–14.8 years) comprising 153,193 individual days of surveillance (in- and outpatient days during intensive treatment). Broviac catheters were used in 63 % of all patients and Ports in 20 %. One hundred forty-two patients (18 %; 95 % CI 16 to 21 %) experienced at least one BSI (179 BSIs in total; bacteraemia 70 %, bacterial sepsis 27 %, candidaemia 2 %). In 57 %, the BSI occurred in inpatients, in 79 % after conventional chemotherapy. Only 56 % of the patients showed neutropenia at BSI onset. Eventually, patients with acute lymphoblastic leukaemia (ALL) or acute myeloblastic leukaemia (AML), relapsed malignancy and patients with a Broviac faced an increased risk of BSI in the multivariate analysis. Relapsed malignancy (16 %) was an independent risk factor for all BSI and for Gram-positive BSI.
Conclusion
: This study confirms relapsed malignancy as an independent risk factor for BSIs in paediatric cancer patients. On a unit level, data on BSIs in this high-risk population derived from prospective surveillance are not only mandatory to decide on empiric antimicrobial treatment but also beneficial in planning and evaluating preventive bundles.
What is Known:
•
Paediatric cancer patients face an increased risk of nosocomial bloodstream infections
(
BSIs
).
•
In most cases
,
these BSIs are associated with the use of a long-term central venous catheter
(
Broviac
,
Port
),
severe and prolonged immunosuppression
(
e.g. neutropenia
)
and other chemotherapy-induced alterations of host defence mechanisms
(
e.g. mucositis
).
What is New:
•
This study is the first multicentre study confirming relapsed malignancy as an independent risk factor for BSIs in paediatric cancer patients
.
•
It describes the epidemiology of nosocomial BSI in paediatric cancer patients mainly outside the stem cell transplantation setting during conventional intensive therapy and argues for prospective surveillance programmes to target and evaluate preventive bundle interventions
.</description><identifier>ISSN: 0340-6199</identifier><identifier>EISSN: 1432-1076</identifier><identifier>DOI: 10.1007/s00431-015-2525-5</identifier><identifier>PMID: 25804192</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Bacteremia - epidemiology ; Bacteremia - microbiology ; Blood-Borne Pathogens ; Cancer Care Facilities - statistics & numerical data ; Cancer therapies ; Candidemia - epidemiology ; Candidemia - microbiology ; Catheter-Related Infections - epidemiology ; Catheter-Related Infections - microbiology ; Catheters ; Chemotherapy ; Child ; Cross Infection - epidemiology ; Cross Infection - microbiology ; Female ; Hematology ; Hospitals ; Hospitals, Pediatric - statistics & numerical data ; Humans ; Infectious diseases ; Leukemia ; Leukemia, Myeloid, Acute - blood ; Leukemia, Myeloid, Acute - epidemiology ; Leukemia, Myeloid, Acute - microbiology ; Male ; Medicine ; Medicine & Public Health ; Neoplasm Recurrence, Local ; Neutropenia ; Nosocomial infections ; Oncology ; Original Article ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - blood ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - microbiology ; Prospective Studies ; Risk Factors</subject><ispartof>European journal of pediatrics, 2015-05, Vol.174 (5), p.675-686</ispartof><rights>Springer-Verlag Berlin Heidelberg 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c485t-a8e96750e84c787b2a99cdcf71f577766c6dc916cda1d9d9cd9078c2895bbe563</citedby><cites>FETCH-LOGICAL-c485t-a8e96750e84c787b2a99cdcf71f577766c6dc916cda1d9d9cd9078c2895bbe563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00431-015-2525-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00431-015-2525-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25804192$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ammann, R. A.</creatorcontrib><creatorcontrib>Laws, H. J.</creatorcontrib><creatorcontrib>Schrey, D.</creatorcontrib><creatorcontrib>Ehlert, K.</creatorcontrib><creatorcontrib>Moser, O.</creatorcontrib><creatorcontrib>Dilloo, D.</creatorcontrib><creatorcontrib>Bode, U.</creatorcontrib><creatorcontrib>Wawer, A.</creatorcontrib><creatorcontrib>Schrauder, A.</creatorcontrib><creatorcontrib>Cario, G.</creatorcontrib><creatorcontrib>Laengler, A.</creatorcontrib><creatorcontrib>Graf, N.</creatorcontrib><creatorcontrib>Furtwängler, R.</creatorcontrib><creatorcontrib>Simon, A.</creatorcontrib><title>Bloodstream infection in paediatric cancer centres—leukaemia and relapsed malignancies are independent risk factors</title><title>European journal of pediatrics</title><addtitle>Eur J Pediatr</addtitle><addtitle>Eur J Pediatr</addtitle><description>In a prospective multicentre study of bloodstream infection (BSI) from November 01, 2007 to July 31, 2010, seven paediatric cancer centres (PCC) from Germany and one from Switzerland included 770 paediatric cancer patients (58 % males; median age 8.3 years, interquartile range (IQR) 3.8–14.8 years) comprising 153,193 individual days of surveillance (in- and outpatient days during intensive treatment). Broviac catheters were used in 63 % of all patients and Ports in 20 %. One hundred forty-two patients (18 %; 95 % CI 16 to 21 %) experienced at least one BSI (179 BSIs in total; bacteraemia 70 %, bacterial sepsis 27 %, candidaemia 2 %). In 57 %, the BSI occurred in inpatients, in 79 % after conventional chemotherapy. Only 56 % of the patients showed neutropenia at BSI onset. Eventually, patients with acute lymphoblastic leukaemia (ALL) or acute myeloblastic leukaemia (AML), relapsed malignancy and patients with a Broviac faced an increased risk of BSI in the multivariate analysis. Relapsed malignancy (16 %) was an independent risk factor for all BSI and for Gram-positive BSI.
Conclusion
: This study confirms relapsed malignancy as an independent risk factor for BSIs in paediatric cancer patients. On a unit level, data on BSIs in this high-risk population derived from prospective surveillance are not only mandatory to decide on empiric antimicrobial treatment but also beneficial in planning and evaluating preventive bundles.
What is Known:
•
Paediatric cancer patients face an increased risk of nosocomial bloodstream infections
(
BSIs
).
•
In most cases
,
these BSIs are associated with the use of a long-term central venous catheter
(
Broviac
,
Port
),
severe and prolonged immunosuppression
(
e.g. neutropenia
)
and other chemotherapy-induced alterations of host defence mechanisms
(
e.g. mucositis
).
What is New:
•
This study is the first multicentre study confirming relapsed malignancy as an independent risk factor for BSIs in paediatric cancer patients
.
•
It describes the epidemiology of nosocomial BSI in paediatric cancer patients mainly outside the stem cell transplantation setting during conventional intensive therapy and argues for prospective surveillance programmes to target and evaluate preventive bundle interventions
.</description><subject>Bacteremia - epidemiology</subject><subject>Bacteremia - microbiology</subject><subject>Blood-Borne Pathogens</subject><subject>Cancer Care Facilities - statistics & numerical data</subject><subject>Cancer therapies</subject><subject>Candidemia - epidemiology</subject><subject>Candidemia - microbiology</subject><subject>Catheter-Related Infections - epidemiology</subject><subject>Catheter-Related Infections - microbiology</subject><subject>Catheters</subject><subject>Chemotherapy</subject><subject>Child</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - microbiology</subject><subject>Female</subject><subject>Hematology</subject><subject>Hospitals</subject><subject>Hospitals, Pediatric - statistics & numerical data</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Leukemia</subject><subject>Leukemia, Myeloid, Acute - blood</subject><subject>Leukemia, Myeloid, Acute - epidemiology</subject><subject>Leukemia, Myeloid, Acute - microbiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasm Recurrence, Local</subject><subject>Neutropenia</subject><subject>Nosocomial infections</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Pediatrics</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - blood</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - microbiology</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><issn>0340-6199</issn><issn>1432-1076</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kc9qFTEUh4Mo9lp9ADcScNPNaM7M5N9Si7WFgpt2Hc5NzpS0M5kxmVm48yF8Qp_EXG4VEdwkgfP9vhP4MfYaxDsQQr8vQvQdNAJk08pWNvIJ20HftQ0IrZ6yneh60Siw9oS9KOVe1IwF85ydtNKIHmy7Y9vHcZ5DWTPhxGMayK9xTvXFF6QQcc3Rc4_JU-aeUuXKz-8_RtoekKaIHFPgmUZcCgU-4RjvUoUjFY6ZqibQQvVIK8-xPPAB_Trn8pI9G3As9OrxPmW3F59uzi-b6y-fr84_XDe-N3Jt0JBVWgoyvddG71u01gc_aBik1lopr4K3oHxACDbUmRXa-NZYud-TVN0pOzt6lzx_3aisborF0zhionkrDqodlJFSV_TtP-j9vOVUf3egegXCyK5ScKR8nkvJNLglxwnzNwfCHTpxx05c7cQdOnGyZt48mrf9ROFP4ncJFWiPQKmjdEf5r9X_tf4Ciu2ZmA</recordid><startdate>20150501</startdate><enddate>20150501</enddate><creator>Ammann, R. A.</creator><creator>Laws, H. J.</creator><creator>Schrey, D.</creator><creator>Ehlert, K.</creator><creator>Moser, O.</creator><creator>Dilloo, D.</creator><creator>Bode, U.</creator><creator>Wawer, A.</creator><creator>Schrauder, A.</creator><creator>Cario, G.</creator><creator>Laengler, A.</creator><creator>Graf, N.</creator><creator>Furtwängler, R.</creator><creator>Simon, A.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20150501</creationdate><title>Bloodstream infection in paediatric cancer centres—leukaemia and relapsed malignancies are independent risk factors</title><author>Ammann, R. A. ; Laws, H. J. ; Schrey, D. ; Ehlert, K. ; Moser, O. ; Dilloo, D. ; Bode, U. ; Wawer, A. ; Schrauder, A. ; Cario, G. ; Laengler, A. ; Graf, N. ; Furtwängler, R. ; Simon, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c485t-a8e96750e84c787b2a99cdcf71f577766c6dc916cda1d9d9cd9078c2895bbe563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Bacteremia - epidemiology</topic><topic>Bacteremia - microbiology</topic><topic>Blood-Borne Pathogens</topic><topic>Cancer Care Facilities - statistics & numerical data</topic><topic>Cancer therapies</topic><topic>Candidemia - epidemiology</topic><topic>Candidemia - microbiology</topic><topic>Catheter-Related Infections - epidemiology</topic><topic>Catheter-Related Infections - microbiology</topic><topic>Catheters</topic><topic>Chemotherapy</topic><topic>Child</topic><topic>Cross Infection - epidemiology</topic><topic>Cross Infection - microbiology</topic><topic>Female</topic><topic>Hematology</topic><topic>Hospitals</topic><topic>Hospitals, Pediatric - statistics & numerical data</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Leukemia</topic><topic>Leukemia, Myeloid, Acute - blood</topic><topic>Leukemia, Myeloid, Acute - epidemiology</topic><topic>Leukemia, Myeloid, Acute - microbiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasm Recurrence, Local</topic><topic>Neutropenia</topic><topic>Nosocomial infections</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Pediatrics</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - blood</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - microbiology</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ammann, R. A.</creatorcontrib><creatorcontrib>Laws, H. J.</creatorcontrib><creatorcontrib>Schrey, D.</creatorcontrib><creatorcontrib>Ehlert, K.</creatorcontrib><creatorcontrib>Moser, O.</creatorcontrib><creatorcontrib>Dilloo, D.</creatorcontrib><creatorcontrib>Bode, U.</creatorcontrib><creatorcontrib>Wawer, A.</creatorcontrib><creatorcontrib>Schrauder, A.</creatorcontrib><creatorcontrib>Cario, G.</creatorcontrib><creatorcontrib>Laengler, A.</creatorcontrib><creatorcontrib>Graf, N.</creatorcontrib><creatorcontrib>Furtwängler, R.</creatorcontrib><creatorcontrib>Simon, A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ammann, R. A.</au><au>Laws, H. J.</au><au>Schrey, D.</au><au>Ehlert, K.</au><au>Moser, O.</au><au>Dilloo, D.</au><au>Bode, U.</au><au>Wawer, A.</au><au>Schrauder, A.</au><au>Cario, G.</au><au>Laengler, A.</au><au>Graf, N.</au><au>Furtwängler, R.</au><au>Simon, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bloodstream infection in paediatric cancer centres—leukaemia and relapsed malignancies are independent risk factors</atitle><jtitle>European journal of pediatrics</jtitle><stitle>Eur J Pediatr</stitle><addtitle>Eur J Pediatr</addtitle><date>2015-05-01</date><risdate>2015</risdate><volume>174</volume><issue>5</issue><spage>675</spage><epage>686</epage><pages>675-686</pages><issn>0340-6199</issn><eissn>1432-1076</eissn><abstract>In a prospective multicentre study of bloodstream infection (BSI) from November 01, 2007 to July 31, 2010, seven paediatric cancer centres (PCC) from Germany and one from Switzerland included 770 paediatric cancer patients (58 % males; median age 8.3 years, interquartile range (IQR) 3.8–14.8 years) comprising 153,193 individual days of surveillance (in- and outpatient days during intensive treatment). Broviac catheters were used in 63 % of all patients and Ports in 20 %. One hundred forty-two patients (18 %; 95 % CI 16 to 21 %) experienced at least one BSI (179 BSIs in total; bacteraemia 70 %, bacterial sepsis 27 %, candidaemia 2 %). In 57 %, the BSI occurred in inpatients, in 79 % after conventional chemotherapy. Only 56 % of the patients showed neutropenia at BSI onset. Eventually, patients with acute lymphoblastic leukaemia (ALL) or acute myeloblastic leukaemia (AML), relapsed malignancy and patients with a Broviac faced an increased risk of BSI in the multivariate analysis. Relapsed malignancy (16 %) was an independent risk factor for all BSI and for Gram-positive BSI.
Conclusion
: This study confirms relapsed malignancy as an independent risk factor for BSIs in paediatric cancer patients. On a unit level, data on BSIs in this high-risk population derived from prospective surveillance are not only mandatory to decide on empiric antimicrobial treatment but also beneficial in planning and evaluating preventive bundles.
What is Known:
•
Paediatric cancer patients face an increased risk of nosocomial bloodstream infections
(
BSIs
).
•
In most cases
,
these BSIs are associated with the use of a long-term central venous catheter
(
Broviac
,
Port
),
severe and prolonged immunosuppression
(
e.g. neutropenia
)
and other chemotherapy-induced alterations of host defence mechanisms
(
e.g. mucositis
).
What is New:
•
This study is the first multicentre study confirming relapsed malignancy as an independent risk factor for BSIs in paediatric cancer patients
.
•
It describes the epidemiology of nosocomial BSI in paediatric cancer patients mainly outside the stem cell transplantation setting during conventional intensive therapy and argues for prospective surveillance programmes to target and evaluate preventive bundle interventions
.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>25804192</pmid><doi>10.1007/s00431-015-2525-5</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0340-6199 |
| ispartof | European journal of pediatrics, 2015-05, Vol.174 (5), p.675-686 |
| issn | 0340-6199 1432-1076 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1675168557 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Bacteremia - epidemiology Bacteremia - microbiology Blood-Borne Pathogens Cancer Care Facilities - statistics & numerical data Cancer therapies Candidemia - epidemiology Candidemia - microbiology Catheter-Related Infections - epidemiology Catheter-Related Infections - microbiology Catheters Chemotherapy Child Cross Infection - epidemiology Cross Infection - microbiology Female Hematology Hospitals Hospitals, Pediatric - statistics & numerical data Humans Infectious diseases Leukemia Leukemia, Myeloid, Acute - blood Leukemia, Myeloid, Acute - epidemiology Leukemia, Myeloid, Acute - microbiology Male Medicine Medicine & Public Health Neoplasm Recurrence, Local Neutropenia Nosocomial infections Oncology Original Article Pediatrics Precursor Cell Lymphoblastic Leukemia-Lymphoma - blood Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology Precursor Cell Lymphoblastic Leukemia-Lymphoma - microbiology Prospective Studies Risk Factors |
| title | Bloodstream infection in paediatric cancer centres—leukaemia and relapsed malignancies are independent risk factors |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T18%3A09%3A08IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Bloodstream%20infection%20in%20paediatric%20cancer%20centres%E2%80%94leukaemia%20and%20relapsed%20malignancies%20are%20independent%20risk%20factors&rft.jtitle=European%20journal%20of%20pediatrics&rft.au=Ammann,%20R.%20A.&rft.date=2015-05-01&rft.volume=174&rft.issue=5&rft.spage=675&rft.epage=686&rft.pages=675-686&rft.issn=0340-6199&rft.eissn=1432-1076&rft_id=info:doi/10.1007/s00431-015-2525-5&rft_dat=%3Cproquest_cross%3E3661219961%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1674610853&rft_id=info:pmid/25804192&rfr_iscdi=true |