Risk Factors Associated With Invasive Fungal Disease in Children With Cancer and Febrile Neutropenia A Prospective Multicenter Evaluation

Simple item page
dc.contributor.authorVillarroel, Milena
dc.contributor.authorAviles, Carmen L.
dc.contributor.authorSilva, Pamela
dc.contributor.authorGuzman, Ana M.
dc.contributor.authorPoggi, Helena
dc.contributor.authorAlvarez, Ana M.
dc.contributor.authorBecker, Ana
dc.contributor.authorO'Ryan, Miguel
dc.contributor.authorSalgado, Carmen
dc.contributor.authorTopelberg, Santiago
dc.contributor.authorTordecilla, Juan
dc.contributor.authorVaras, Monica
dc.contributor.authorViviani, Tamara
dc.contributor.authorZubieta, Marcela
dc.contributor.authorSantolaya, Maria E.
dc.date.accessioned2024-01-10T13:17:18Z
dc.date.available2024-01-10T13:17:18Z
dc.date.issued2010
dc.description.abstractBackground: Empiric antifungal treatment has become standard of care in children with cancer and prolonged fever and febrile neutropenia (FN), with the downside that it leads to significant over treatment. We characterized epidemiologic, clinical, and laboratory features of invasive fungal disease (IFD) in children with cancer and FN with the aim to identify risk factors for IFD that can aid in better selecting children who require antifungal treatment.
dc.description.abstractMethods: In a prospective, multicenter study, children admitted with FN at high-risk for sepsis, in 6 hospitals in Santiago, Chile were monitored from admission until the end of the FN episode. Monitoring included periodic evaluation of clinical findings, absolute neutrophil count, absolute monocyte count (AMC), serum C-reactive protein (CRP), bacterial cultures, imaging studies, and galactomannan antigen. A diagnosis of proven, probable, and possible IFD was made after episode resolution based on European Organization for Research and Treatment of Cancer classification.
dc.description.abstractResults: A total of 646 high-risk FN episodes were admitted during the study period, of which 604 were enrolled. IFD was diagnosed in 35 episodes (5.8%) of which 7 (1.2%) were proven, 10 (1.6%) probable, and 18 (3.0%) possible. Four variables obtained on day 4 were significantly more common in IFD cases, which were presence of fever, absolute neutrophil count <= 500/mm(3), AMC <= 100/mm(3), and CRP >= 90 mg/L. The combination of fever, AMC <= 100/mm(3), and CRP >= 90 at day 4 provided a RR for IFD of 5.4 (99% CI, 3.2-9.2) with a sensitivity of 75%, specificity of 87%, positive and negative predictive values of 13% and 99%, respectively.
dc.description.abstractConclusions: Fever persisting at day 4 of admission, together with AMC <= 100 and CRP >= 90 significantly increased the risk for IFD in children with cancer.
dc.description.funderProyecto FONDECYT
dc.description.funderFundacion Nuestros hijos
dc.fechaingreso.objetodigital2024-05-15
dc.format.extent6 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1097/INF.0b013e3181e7db7f
dc.identifier.eissn1532-0987
dc.identifier.issn0891-3668
dc.identifier.pubmedidMEDLINE:20616763
dc.identifier.urihttps://doi.org/10.1097/INF.0b013e3181e7db7f
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/78653
dc.identifier.wosidWOS:000281124300005
dc.information.autorucMedicina;Guzmán A;S/I;117075
dc.information.autorucMedicina;Poggi H;S/I;115999
dc.issue.numero9
dc.language.isoen
dc.nota.accesoSin adjunto
dc.pagina.final821
dc.pagina.inicio816
dc.publisherLIPPINCOTT WILLIAMS & WILKINS
dc.revistaPEDIATRIC INFECTIOUS DISEASE JOURNAL
dc.rightsregistro bibliográfico
dc.subjectinvasive fungal disease
dc.subjectfebrile neutropenia
dc.subjectrisk factors
dc.subjectBLOOD-STREAM INFECTIONS
dc.subjectBACTERIAL-INFECTION
dc.subjectANTIFUNGAL THERAPY
dc.subjectPEDIATRIC-PATIENTS
dc.subjectCANDIDA-ALBICANS
dc.subjectDIAGNOSIS
dc.subjectASPERGILLOSIS
dc.subjectGALACTOMANNAN
dc.subjectPCR
dc.subjectEPIDEMIOLOGY
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleRisk Factors Associated With Invasive Fungal Disease in Children With Cancer and Febrile Neutropenia A Prospective Multicenter Evaluation
dc.typeartículo
dc.volumen29
sipa.codpersvinculados117075
sipa.codpersvinculados115999
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Risk Factors Associated With Invasive Fungal Disease in Children With Cancer and Febrile Neutropenia.pdf
Size:
106.39 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Artículos de revistas