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febrile neutropenic

Christopher A Benner, Erika Mora, Emily Mueller, F Jacob Seagull, Kelly Walkovich, Kaleena Johnson, Schuyler Halverson, Ed Rothman, George Hucks, John G Younger, Michele M Nypaver
OBJECTIVES: Febrile neutropenic pediatric patients are at heightened risk for serious bacterial infections, and rapid antibiotic administration (in <60 minutes) improves survival. Our objectives were to reduce the time-to-antibiotic (TTA) administration and to evaluate the effect of overall emergency department (ED) busyness on TTA. METHODS: This study was a quality improvement initiative with retrospective chart review to reduce TTA in febrile children with underlying diagnosis of cancer or hematologic immunodeficiency who visited the pediatric ED...
October 4, 2016: Pediatric Emergency Care
Alberto A Carena, Laura Jorge, Pablo Bonvehí, Elena Temporiti, Mariela S Zárate, Fabián Herrera
Fluorquinolone-prophylaxis has proven useful in preventing infections in high risk neutropenic patients. The objective of this study was to describe the clinical, microbiological and therapeutic characteristics, and outcome of patients in the first episode of febrile neutropenia, comparing those who received levofloxacin prophylaxis with those who didn't. It was a prospective observational study that included all the episodes of inpatients with febrile neutropenia (February 1997- November 2014), also including the first episode in a same patient in different hospitalizations...
2016: Medicina
Jina Lee
No abstract text is available yet for this article.
September 2016: Infection & Chemotherapy
Maurizio Bernasconi, Alessio Casutt, Angela Koutsokera, Igor Letovanec, Frédéric Tissot, Laurent P Nicod, Alban Lovis
The role of radial-endobronchial ultrasound (R-EBUS) assisted transbronchial biopsy (TBB) for the diagnosis of peripheral pulmonary lesions is well established. However, no study has addressed its safety and value in hemato-oncological patients presenting with non-resolving infiltrates during persistent febrile neutropenia. To assess safety and feasibility of R-EBUS assisted TBB in severe thrombocytopenic and neutropenic patients. Over a period of 18 months, eight patients were assessed with R-EBUS assisted TBB after adequate platelet transfusion...
October 4, 2016: Lung
K Govind Babu, D Lokanatha, K C Lakshmaiah, M C Suresh Babu, Linu A Jacob, Gita R Bhat, Harsha Vardhana, Mahua Sinha, B R Vijaykumar, B G Sumati, R S Jayshree
INTRODUCTION: Febrile neutropenia (FN) is an oncological emergency. The choice of empiric therapy depends on the locally prevalent pathogens and their sensitivities, the sites of infection, and cost. The Infectious Diseases Society of America guidelines are being followed for the management of FN in India. METHODS: This is a prospective observational study conducted at a tertiary care cancer centre from September 2012 to September 2014. OBJECTIVES: The objectives of this study were as follows: (1) To review the pattern of microbial flora, susceptibility pattern, and important clinical variables among bloodstream infections in febrile neutropenic patients with solid tumors and hematological malignancies...
July 2016: Indian Journal of Medical and Paediatric Oncology
A Forcina, R Baldan, V Marasco, P Cichero, A Bondanza, M Noviello, S Piemontese, C Soliman, R Greco, F Lorentino, F Giglio, C Messina, M Carrabba, M Bernardi, J Peccatori, M Moro, A Biancardi, P Nizzero, P Scarpellini, D M Cirillo, N Mancini, C Corti, M Clementi, F Ciceri
Carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) infections are an emerging cause of death after hematopoietic stem cell transplantation (HSCT). In allogeneic transplants, mortality rate may rise up to 60%. We retrospectively evaluated 540 patients receiving a transplant from an auto- or an allogeneic source between January 2011 and October 2015. After an Institutional increase in the prevalence of KPC-Kp bloodstream infections (BSI) in June 2012, from July 2012, 366 consecutive patients received the following preventive measures: (i) weekly rectal swabs for surveillance; (ii) contact precautions in carriers (iii) early-targeted therapy in neutropenic febrile carriers...
September 26, 2016: Bone Marrow Transplantation
Sabina Bialkowski, Christine E Staatz, Julia Clark, Rachael Lawson, Stefanie Hennig
BACKGROUND: The pharmacokinetics of gentamicin in pediatric febrile neutropenia patients is described and the adequacy of initial dosing of once daily gentamicin assessed at Queensland's largest Children's Hospital. METHODS: Data were retrospectively collected from all pediatrics with febrile neutropenia admitted over a two-year period who had at least two gentamicin concentration-time measurements (a paired set within one dosing interval). Gentamicin clearance (CL), volume of distribution (Vd), area under the concentration-time curve from 0 to 24 hours post-dose (AUC0-24), and maximum concentration (Cmax) values were estimated using log-linear regression using each paired set...
September 16, 2016: Therapeutic Drug Monitoring
Joon Hee Lee, Seul Ki Kim, Seong Koo Kim, Seung Beom Han, Jae Wook Lee, Dong Gun Lee, Nack Gyun Chung, Bin Cho, Dae Chul Jeong, Jin Han Kang, Hack Ki Kim
BACKGROUND: The incidence of bacteremia caused by Gram-negative bacteria has increased recently in febrile neutropenic patients with the increase of antibiotic-resistant Gram-negative bacterial infections. This study aimed to identify the distribution of causative bacteria and the proportion of antibiotic-resistant bacteria in bacteremia diagnosed in febrile neutropenic children. MATERIALS AND METHODS: The medical records of febrile neutropenic children diagnosed with bacteremia between 2010 and 2014 were retrospectively reviewed...
September 2016: Infection & Chemotherapy
Gladys Villas Boas do Prado, Ana Paula Marchi, Luisa Zanolli Moreno, Camila Rizek, Ulisses Amigo, Andrea Micke Moreno, Flavia Rossi, Thais Guimaraes, Anna Sara Levin, Silvia F Costa
Empirical use of linezolid has been advocated in neutropenic febrile patients colonised by vancomycin-resistant enterococci (VRE) because of the risk of bloodstream infection (BSI). This study aimed to genetically describe a vancomycin-resistant Enterococcus faecium (VREfm) BSI isolate resistant to linezolid (VRLRE) in a patient previously colonised by VREfm and to determine the incidence of colonisation and infection by VREfm in a bone marrow transplant unit over a 10-year period. Data for VREfm colonisation and infection were evaluated...
September 2016: Journal of Global Antimicrobial Resistance
Luciana Teofili, Caterina Giovanna Valentini, Roberta Di Blasi, Nicoletta Orlando, Luana Fianchi, Gina Zini, Simona Sica, Valerio De Stefano, Livio Pagano
It is still under debate whether granulocyte transfusions (GTs) substantially increase survival in patients with febrile neutropenia. We retrospectively examined data relative to 96 patients with hematological malignancies receiving 491 GTs during 114 infectious episodes (IE). Patients were grouped according to the median doses of granulocytes transfused during the infectious episode (low-dose group: <1.5-x108 cells/Kg; standard-dose group: 1.5-3.0x108 cells/Kg and high-dose group: >3.0x108 cells/Kg)...
2016: PloS One
V Noronha, C Goswami, S Patil, A Joshi, V M Patil, V Murthy, S Arya, S Juvekar, S Goud, K Prabhash
BACKGROUND: Docetaxel, cisplatin plus 5-fluorouracil is an efficacious induction regimen but is more toxic than cisplatin plus 5-fluorouracil. This study aimed to determine whether docetaxel and cisplatin without 5-fluorouracil maintains efficacy while decreasing toxicity. METHODS: A multicenter non-comparative pilot study of locally advanced squamous cell carcinoma of the head and neck was performed. Patients received primary therapy comprising three cycles of 75 mg/m2 docetaxel and 75 mg/m2 cisplatin followed by concurrent chemoradiotherapy...
September 2016: Journal of Laryngology and Otology
Graeme Mattison, Matthew Bilney, Phil Haji-Michael, Tim Cooksley
PURPOSE: Neutropenic sepsis is a time-dependent emergency with early interventions shown to improve outcomes. Broad spectrum intravenous antibiotic administration is the initial therapy in patients with suspected neutropenic sepsis. Compliance with early antibiotic administration in febrile neutropenia patients is poor. Innovations have been trialled to improve the time to first dose intravenous antibiotics in patients with suspected neutropenic sepsis. Consideration of extending first dose intravenous antibiotic prescribing to trained nursing staff may improve performance in this key standard...
July 25, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
S Desmet, J Maertens, K Bueselinck, K Lagrou
Infection is an important complication in patients with hematologic malignancies or solid tumors undergoing intensive cytotoxic chemotherapy. In only 20 to 30% of the febrile neutropenic episodes, an infectious agent is detected by conventional cultures. In this prospective study, the performance of broad-range PCR coupled with electrospray ionization time of flight mass spectrometry (PCR/ESI-MS) technology was compared to conventional blood cultures (BC) in a consecutive series of samples from high-risk hematology patients...
October 2016: Journal of Clinical Microbiology
Vural Kesik, Erman Ataş, Yasemin Gülcan Kurt, Fevzi Nuri Aydın, Oğuzhan Babacan, Mustafa Gülgün, Nadir Korkmazer
AIM OF STUDY: Neutropenic fever is a source of morbidity and mortality in children with cancer. It is not possible to detect the causative agent in cultures in most cases; the research for a marker that can show the severity of the disease is ongoing. We evaluated the role of adrenomedullin (ADM) at predicting prognosis on patients with febrile neutropenia, which has been proven to be a good prognostic marker for diseases with high morbidity and mortality, such as heart failure, ischemic ventricular dysfunction, sepsis, and systemic inflammatory response syndrome...
September 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Robert S Phillips, Kaljit Bhuller, Lillian Sung, Roland A Ammann, Wim J E Tissing, Thomas Lehrnbecher, Lesley A Stewart
BACKGROUND: Risk-stratified management of febrile neutropenia (FN) allows intensive management of high-risk cases and early discharge of low-risk cases. Most risk stratification systems predicting severe infection from admission variables have been derived from childhood or adult populations and consequently their value in adolescents/young adults (AYA) may vary. Our objective was to determine their value in this population. METHODS: Data from the 'predicting infectious complications in children with cancer' (PICNICC) individual participant data collaboration were used to evaluate six previously described risk stratification schema in the AYA population...
September 2016: European Journal of Cancer
H K Jahn, S Barraclough, S Currell, M P Tighe
We describe the management of a 4-year-old child with acute lymphoblastic leukaemia (ALL) who presented with febrile neutropenia, Cryptosporidium and subsequently developed refeeding syndrome. Febrile neutropenia is common and can be life-threatening and we highlight the identification of well low-risk neutropenic children with resolved febrile illnesses suitable for early discharge. We also discuss the potential management strategies for Cryptosporidium Refeeding syndrome is not common, but should be considered as a cause of acute inpatient deterioration and is a significant risk, with potential morbidity, in children who have undergone a period of catabolism...
July 7, 2016: Archives of Disease in Childhood. Education and Practice Edition
Kyong-Hwa Park, Yoon Ji Choi, Kwan-Woo Kim, Kyung-Han Ro, Chang Ho Kang, Sang-Heon Song, Jong Hoon Park
OBJECTIVE: To elucidate the clinical benefit and safety of low-dose chemotherapy using methotrexate and vinblastine in patients (mostly adults) with progressive and/or symptomatic fibromatosis. METHODS: Patients were enrolled if they were treated with methotrexate and vinblastine chemotherapy for recurrences after surgical excision or newly diagnosed aggressive fibromatosis that was not amenable to surgical resection at the Korea University Medical Center from May 2008 to February 2016...
September 2016: Japanese Journal of Clinical Oncology
Shiro Sugiura, Tsuyoshi Ito, Norihisa Koyama, Noriko Sasaki, Hiroshi Ikai, Yuichi Imanaka
BACKGROUND: Febrile neutropenia (FN) can be a life-threatening complication in children with malignancies. There is no standardized preventive treatment for childhood FN, and information on C-reactive protein (CRP) elevation in afebrile patients with neutropenia (CEAN) is limited. We aimed to identify the association between CEAN and FN onset, and evaluate the efficacy of broad-spectrum antibiotics for FN prophylaxis. METHODS: We retrospectively reviewed the medical records of 22 consecutive pediatric patients with hematologic malignancies (2 acute myeloid leukemia and 20 acute lymphoid leukemia cases) admitted to our institution between 2006 and 2011...
June 30, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Nur Efe İris, Taner Yıldırmak, Habip Gedik, Funda Şimşek, Demet Aydın, Naciye Demirel, Osman Yokuş
OBJECTIVE: The aim of this study is to investigate if neutrophil CD64 expression in febrile neutropenia patients could be used as an early indicator of bacteriemia. PATIENTS-METHODS: All consecutive patients, older than 18 years of age and developed febrile neutropenia episodes due to hematological malignancies from February 2013-to July 2013 at the hematology department of Okmeydanı Training and Research Hospital, Istanbul, Turkey were included into the study...
June 27, 2016: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
Shu-Dao Xiong, Lian-Fang Pu, Hui-Ping Wang, Lin-Hui Hu, Yang-Yang Ding, Man-Man Li, Dong-Dong Yang, Cui Zhang, Jing-Xin Xie, Zhi-Min Zhai
BACKGROUND: In the hematology department, the availability of biomarkers for early detection of infection is difficult to obtain. The present study aimed to compare the diagnostic values of neutrophil CD64 Index, procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP) and to determine whether the combined analysis of these biomarkers offer stronger predictive power in the diagnosis for the infection of febrile patients. METHODS: Neutrophil CD64 Index, PCT, IL-6 and CRP levels were determined in 356 febrile patients in the hematology ward from May 2013 to May 2015...
June 23, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
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