Background: Aggressive protocols for treatment of NB, stressing the potential increased risk for complications in comparison with other STL.
Aims: To characterize and compare clinical course and bacteriology of febrile episodes between children with NB and STL.
Methods: Data from all febrile episodes in children with STL and NB in 5 Israeli hospitals were prospectively collected during 2008-2009, including: demographic, clinical, laboratory , bacteriology, treatment and outcome. A comparison between NB and STL was conducted.
Results: There were 40 episodes among 23 patients with NB, and 415 episodes among 164 patients with STL. Demographic data were similar except younger age in NB vs. STL (mean 38±28 vs. 110±79 months p=0.000). Patients with NB more frequently had Hickman catheters (30% vs. 15.5% p=0.02), and intensive chemotherapy (97.5% vs. 75.4% p=0.007). No differences were seen in length of neutropenic episodes. Nadir was deeper in STL group (63±108cells/mm³ vs 118±154 p= 0.03). Diagnosis were fever without source 77% in STL , 80% in NB, and CVC associated infection or bacteremia in 9.5% in STL and 7.5 % in NB; Gastrointestinal related infection in 4.3% in STL and 0% in NB, UTI in 3.7% in STL, 7.5% in NB. All were not significant. There were 80 pathogens in the STL group (21% of episodes), 67.5% gram+, 27.5% gram-, 5 % candida. 6 pathogens in NB (15% of episodes) , 83% gram+, 17% gram-. Four patients with STL died.
Conclusions: No significant differences between study groups in terms of type of infections, and bacteriology.
The study was supported -Hipak Grant2007
