Factores de riesgo para bacteriemia en neutropenia febril en pacientes pediátricos Hemato-Oncológicos

Abstract

Aim: Febrile neutropenia is a frequent complication, with high mortality, of hemato/oncology patients receiving chemotherapy. In Latinamerica there are few studies showning clinical or laboratory criteria to classify the patients in high risk for bacteremia, associated to fever with neutropenia. Methods: This is a retrospective, observational study. All hemato-oncology patients admitted at the Hospital pediatric, from January 1st, 2016 to July 31, 2017 with febrile neutropenia due to chemotherapy were included. Results:  318 episodes of fever and neutropenia due to chemotherapy were included of a total of 170 patients with cancer during the 19 months of the study.  77% of the episodes were classified as high risk for severe sepsis for bacteremia after analysis. 2.2% had positive blood culture with a prevalence of Gram’s negative bacteria (62,5%). There were no deaths. The study population demonstrates higher risk for bacteremia on patients presenting hypotension (OR: 29.9), a central catheter (OR: 8.1) and platelets count of ≤ 50000/mm³ (OR: 5.0). Conclusion: With these results, it has been validated clinical and laboratory parameters that can be applied to the costarican population, to stratify the risk for bacteremia of patients with fever and neutropenia. This, in the future, optimizing the assessment and the appropriate empiric antimicrobial coverage, reducing the antimicrobial resistance and improving the outcome of complications of patients with cancer.