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Boletín Médico del Hospital Infantil de México

2013, Number 4

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Bol Med Hosp Infant Mex 2013; 70 (4)

Frequency of risk factors for bacteremia in children with cancer, neutropenia and fever in a tertiary level hospital in western Mexico

Lona RJC, Marín AM, Cordero ZA, Gaitán MJ

Language: Spanish
References: 23
Page: 304-309
PDF size: 216.06 Kb.


ABSTRACT

Background. We undertook this study to identify risk factors (RF) for bacteremia in children with cancer, neutropenia and fever (CNF) in order to establish more timely diagnoses.
Methods. We conducted a cross-sectional study in regard to RF for bacteremia in pediatric patients with CNF. We compared the prevalence of bacteremia depending on the presence or absence of independent variables and calculated the prevalence ratio (PR) with 95% confidence intervals. Multivariate analysis was performed to identify conditions that increase the likelihood of the diagnosis of bacteremia. Results. We included 149 patients with CNF. Average age was 7.3 years; 45% were females. The underlying disease was leukemia (n = 113) or solid tumors (n = 36). Of the patients, 25.5% suffered from bacteremia; 65% of isolated bacteria were gram-negative. Variables associated with bacteremia identified by multivariate analysis were thrombocytopenia (OR 2.3, 95% CI 1.02-5.4, p 0.04), central venous catheter (CVC) (OR 2.6, 95% CI 1.16-5.9, p 0.02) and history of chemotherapy with vincristine (OR 2.8, 95% CI 1.22-6.4, p 0.01).
Conclusions. In a multivariate model, platelet count ≤50,000/mm3, CVC and the use of vincristine were associated with an increased likelihood of diagnosis of bacteremia in children with CNF.


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