All issues > Volume 35(11); 1992

Original Article

J Korean Pediatr Soc. 1992;35(11):1481-1492. Published online November 15, 1992.

Septicemia in Children with Neoplastic Disease

Bo Young BY Yun¹, Hoan Jong HJ Lee¹

¹Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea

Abstract

This study reviewed 66 episodes of septicemia occurring in 56 children with neoplastic disease at Seoul National University Children뭩 hospital over 31 month period. The most frequent organisms causing 45 episodes in neutropenic patient were Escherichia coli (28%), Klebsiella species (18%), Pseudomonas species (9%), polymicrobic (9%,), and Staphylococcus aureus (7%). The overal mortality was 13% (5/39). The most frequent organisms causing 21 episodes in non-neutropenic patient were S. aureus (19%), polymicrobic, E. coli, Klebsiella species, Salmonella species, viridans streptococci, and Enterococci (9.5% each). No episode in non-neutropenic patient was fatal. All the fatal cases occurred in children with hematologic malignancy, neutropenia, and gram-negative septicemia. Although mortality was higher in children with polymicrobic septicemia than in those with single-organism septicemia, the differences were not significant. The associated focal infection was identified in 50%. Although the mortality was highest when the associated focal infection was in the lung, the differences were not significant. The frequency of methicillin resistance among S. aureus and that of gentamicin resistance among gram-negative enteric organisms were increased when septicemia developed after 48 hours of hospitalization compared to before 48 hours. Neutropenic children who had positive blood culture results while recieving antibiotic therapy had a poor prognosis.

Keywords :Septicemia, Neoplastic disease, Neutropenia, Immunocompromised host