Risk factors for bacteremia in children with febrile neutropenia

Abstract

Background/aim: Bacteremia remains an important cause of morbidity and mortality during febrile neutropenia (FN) episodes. Weaimed to define the risk factors for bacteremia in febrile neutropenic children with hemato-oncological malignancies.Materials and methods: The records of 150 patients aged ≤18 years who developed FN in hematology and oncology clinics wereretrospectively evaluated. Patients with bacteremia were compared to patients with negative blood cultures.Results: The mean age of the patients was 7.5 ± 4.8 years. Leukemia was more prevalent than solid tumors (61.3% vs. 38.7%). Bacteremiawas present in 23.3% of the patients. Coagulase-negative staphylococci were the most frequently isolated microorganism. Leukopenia,severe neutropenia, positive peripheral blood and central line cultures during the previous 3 months, presence of a central line, previousFN episode(s), hypotension, tachycardia, and tachypnea were found to be risk factors for bacteremia. Positive central line culturesduring the previous 3 months and presence of previous FN episode(s) were shown to increase bacteremia risk by 2.4-fold and 2.5-fold,respectively.Conclusion: Presence of a bacterial growth in central line cultures during the previous 3 months and presence of any previous FNepisode(s) were shown to increase bacteremia risk by 2.4-fold and 2.5-fold, respectively. These factors can predict bacteremia in childrenwith FN.