Conflict of interest: Nothing to declare.
Invasive bacterial and fungal infections in paediatric patients with cancer: Incidence, risk factors, aetiology and outcomes in a UK regional cohort 2009–2011
Article first published online: 24 FEB 2014
© 2014 Wiley Periodicals, Inc.
Pediatric Blood & Cancer
Volume 61, Issue 7, pages 1239–1245, July 2014
How to Cite
Calton, E. A., Le Doaré, K., Appleby, G., Chisholm, J. C., Sharland, M., Ladhani, S. N. and CABIN Participants (2014), Invasive bacterial and fungal infections in paediatric patients with cancer: Incidence, risk factors, aetiology and outcomes in a UK regional cohort 2009–2011. Pediatr. Blood Cancer, 61: 1239–1245. doi: 10.1002/pbc.24995
- Issue published online: 2 MAY 2014
- Article first published online: 24 FEB 2014
- Manuscript Accepted: 30 JAN 2014
- Manuscript Received: 5 OCT 2013
- European Society for Paediatric Infectious Diseases (ESPID)
- antimicrobial drug resistance;
- bacterial infections and mycoses;
- catheter-associated infections;
Cancer is the second most common cause of childhood deaths in the United Kingdom and infection contributes to a quarter of all cancer-related deaths. This study aimed to estimate the risk, aetiology and outcome of bloodstream bacterial and fungal infections in children with cancer within a geographically defined region in South-West London over a 3-year period.
Web-based questionnaires were completed using case records of children with positive blood cultures admitted to five London hospitals during 2009–2011.
A total of 112 children with a median age of 5.4 (IQR 3.6–11.2) years had 266 significant blood cultures during 149 infection episodes. Haematological malignancy affected 68 patients (60.7%) and solid tumours 44 (39.3%). The overall bloodstream infection rate was 1.5 episodes per 1,000 days-at-risk (95% CI, 1.2–1.8) and was similar for those with haematological malignancies and solid tumours. Most episodes were attributed to central venous catheter infection (120/149, 80.5%). Coagulase-negative staphylococci were isolated in almost half the bloodstream infections (127/266; 47.7%), while Gram-negative organisms accounted for a further quarter (64/266; 24.1%). Fungal isolates from blood were uncommon (8/112 children, 7.1%) but significantly associated with neutropenia (18/149 [12.1%] vs. 1/114 [0.9%], P = 0.0004). Six children (5.4%) died, including three (2.7%; 95% CI, 0.6–7.6%) whose deaths were infection-related.
This study provides an updated risk estimate for bloodstream infections in children with cancer and adds to the framework for developing evidence-based guidance for management of suspected infections in this highly vulnerable group. Pediatr Blood Cancer 2014;61:1239–1245. © 2014 Wiley Periodicals, Inc.