부산대학교 도서관

Objective: This study aimed to evaluate the epidemiological, microbiological, clinical characteristics of the patients followed up with different types of underlying hematologic malignancies and solid tumors. Method: This cohort study included patients with pediatric malignancy. Eighty- eight patients who were followed up for two years were included. The number of days from the first diagnosis, recurrent infectious episodes, number of days with fever, presence of neutropenia and nonneutropenic episodes, chemotherapy regimens, antimicrobial agents, blood and urinary tract culture samples were recorded. Results: A total of 149 infectious episodes were observed. The median age was 5.08 years. The mean age was 9.02 [+ or -] 5.17 years in patients who had no infectious episodes during the follow-up and 5.70 [+ or -] 4.60 years in patients with two and more infectious episodes and was significantly lower (p=0.024). In total, 264 microbial cultures were retrieved from different locations during these infectious episodes. Regarding all the cultures, 27% of blood cultures and 9% of urinary tract cultures were positive. The most commonly isolated microorganism were Gram-positive bacteria (n=23, 57.5%). Conclusion: Younger children with cancer are at higher risk of infection complications compared to children of older ages. Children with hematologic malignancies are more likely to develop a neutropenic fever during the consolidation and induction periods. Regarding the high rate of FUO in our study, more attempts to increase microbiological diagnosis in this patient population. Keywords: Febrile neutropenia, cancer, pediatrics Amac: Bu calismada, altta yatan farkli tipte hematolojik maligniteler ve solid tumorler ile takip edilen hastalarin epidemiyolojik, mikrobiyolojik, klinik ozelliklerinin degerlendirilmesi amaclanmistir. Yontem: Bu kohort calismasina pediatrik maligniteli hastalar dahil edilmistir. Iki yil takip edilen 88 hasta calismaya dahil edildi. Ilk tanidan itibaren gun sayisi, tekrarlayan enfeksiyoz ataklar, atesli gun sayisi, notropeni ve notropenik olmayan atak varligi, kemoterapi rejimleri, antimikrobiyal ajanlar, kan ve idrar yolu kultur ornekleri kaydedildi. Bulgular: Toplam 149 enfeksiyoz epizod gozlendi. Takipte enfeksiyoz epizodu olmayanlarda yas ortalamasi 9,02 [+ or -] 5,17 yil iken, iki ve daha fazla enfeksiyoz epizodu olanlarda 5,70 [+ or -] 4,60 yildi ve anlamli olarak daha dusuktu (p=0,024). Bu enfeksiyoz epizodlar sirasinda farkli yerlerden toplamda 264 mikrobiyal kultur alindi. Tum kulturlerde kan kulturlerinin %27'si ve idrar yolu kulturlerinin %9'u pozitifti. En sik izole edilen mikroorganizma Gram-pozitif bakterilerdi (n=23, %57,5). Sonuc: Pediatrik cagdaki kanserlerde yas azaldikca daha yuksek enfeksiyon komplikasyonlari riski izlenmistir. Hematolojik maligniteleri olan cocuklarin konsolidasyon ve induksiyon donemlerinde notropenik ates gelistirme olasiligi daha yuksektir. Calismamizdaki nedeni bilinmeyen ates oranlarindan da yola cikarak bu grup hastaliklarda daha iyi mikrobiyolojik tani icin daha fazla calisma gerekmektedir. Anahtar kelimeler: Febril notropeni, kanser, cocuk
INTRODUCTION Children treated for cancer develop serious complications even death during episodes of infectious complications, most of them being associated with neutropenic fever (1). Studies have revealed that during the [...]