Tisungane Mvalo1, Brian Eley2, Colleen Bamford3, Christopher Stanley4, Maganizo Chagomerana4, Marc Hendricks5, Ann Van Eyssen5, Alan Davidson5. 1. Department of Paediatrics, University of Cape Town, Cape Town, South Africa. Electronic address: tisungemvalo@yahoo.com. 2. Paediatric Infectious Diseases Unit, Red Cross War Memorial Children's Hospital, and the Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa. 3. National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa; Department of Medical Microbiology, University of Cape Town, Cape Town, South Africa. 4. University of North Carolina Project Malawi, Lilongwe, Malawi. 5. Haematology-Oncology Unit, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Abstract
OBJECTIVES: This study was performed to investigate the epidemiology of bloodstream infection (BSI) in oncology patients at Red Cross War Memorial Children's Hospital (RCWMCH), Cape Town, with focus placed on the most common causes, complications, and antimicrobial susceptibilities in BSI. METHODS: A retrospective cross-sectional study was conducted in the Haematology-Oncology Unit of RCWMCH. All positive blood cultures from RCWMCH oncology patients obtained in 2012 to 2014 were retrieved to identify cases of BSI. RESULTS: Three hundred and forty-three positive cultures were identified, for 150 BSI episodes among 89 patients; 49.1% of the culture isolates were Gram-positive bacteria, 41.6% were Gram-negative bacteria, and 9.3% were fungal. Coagulase-negative Staphylococcus and viridans group Streptococcus were the most common Gram-positive isolates. Escherichia coli and Klebsiella species were the most common Gram-negative isolates. The majority of BSI episodes occurred in patients with haematological malignancies (74%), in the presence of severe neutropenia (76.4%), and were associated with chemotherapy (88%). Complications occurred in 14% of BSI. Fungal infections had the highest prevalence of complications (21.4%). Three children died during BSI, giving a case-fatality rate of 2%. CONCLUSIONS: BSI in these patients was caused mainly by Gram-positive bacteria and was associated with a low case-fatality rate. These results are consistent with worldwide experience of BSI in paediatric oncology.
OBJECTIVES: This study was performed to investigate the epidemiology of bloodstream infection (BSI) in oncology patients at Red Cross War Memorial Children's Hospital (RCWMCH), Cape Town, with focus placed on the most common causes, complications, and antimicrobial susceptibilities in BSI. METHODS: A retrospective cross-sectional study was conducted in the Haematology-Oncology Unit of RCWMCH. All positive blood cultures from RCWMCH oncology patients obtained in 2012 to 2014 were retrieved to identify cases of BSI. RESULTS: Three hundred and forty-three positive cultures were identified, for 150 BSI episodes among 89 patients; 49.1% of the culture isolates were Gram-positive bacteria, 41.6% were Gram-negative bacteria, and 9.3% were fungal. Coagulase-negative Staphylococcus and viridans group Streptococcus were the most common Gram-positive isolates. Escherichia coli and Klebsiella species were the most common Gram-negative isolates. The majority of BSI episodes occurred in patients with haematological malignancies (74%), in the presence of severe neutropenia (76.4%), and were associated with chemotherapy (88%). Complications occurred in 14% of BSI. Fungal infections had the highest prevalence of complications (21.4%). Three children died during BSI, giving a case-fatality rate of 2%. CONCLUSIONS: BSI in these patients was caused mainly by Gram-positive bacteria and was associated with a low case-fatality rate. These results are consistent with worldwide experience of BSI in paediatric oncology.
Authors: Ibukunoluwa C Akinboyo; Rebecca R Young; Lisa P Spees; Sarah M Heston; Michael J Smith; Yeh-Chung Chang; Lauren E McGill; Paul L Martin; Kirsten Jenkins; Debra J Lugo; Kevin C Hazen; Patrick C Seed; Matthew S Kelly Journal: Open Forum Infect Dis Date: 2020-03-16 Impact factor: 3.835
Authors: Elizabeth A Gulleen; Scott V Adams; Bickey H Chang; Lauren Falk; Riley Hazard; Johnblack Kabukye; Jackie Scala; Catherine Liu; Warren Phipps; Omoding Abrahams; Christopher C Moore Journal: Open Forum Infect Dis Date: 2021-06-10 Impact factor: 3.835