Epidemiologic profile of symptomatic gastroenteritis in pediatric oncology patients receiving chemotherapy.

Abstract

BACKGROUND:

Patients with cancer who receive intensive chemotherapeutic regimens are subject to profound immunosuppression and are susceptible to an extended array of pathogens.

PROCEDURE:

The infectious causes of symptomatic gastroenteritis as evidenced by diarrhea +/- fever, vomiting, and abdominal colic in children following chemotherapy were prospectively monitored at National Cancer Institute, Cairo University.

RESULTS:

A total of 104 diarrhea episodes were recorded in our institution during a 10-month period, of which an infectious cause was detected in 74 (71.1%). Bacterial and fungal pathogens were isolated in culture from 41 (39.4%) and 24 (23.1%), respectively, while Clostridia difficile (C. difficile) and Cryptosporidium parvum (C. parvum) were detected in 15 (14.4%) and 10 (9.6%) of 104 diarrhea episodes following chemotherapy, respectively. Mixed infections were found in 24 of the patients; whereas, no cause was demonstrable in 30. Hospital acquired and mixed infections were the worst as regards morbidity (P = 0.004 and 0.02) and mortality (P = 0.007 and <0.001) of the infectious episode regardless the cause, respectively. On multivariate analysis, C. difficile was associated with the highest mortality rate (OR = 0.04, 95% CI = 0.01-0.19), followed by fungal pathogens (OR = 0.20, 95% CI = 0.05-0.74) and bacterial infections (OR = 0.20, 95% CI = 0.05-0.79).

CONCLUSIONS:

Infectious gastroenteritis is an important cause of morbidity and mortality in hospitalized pediatric cancer patients receiving intensified protocols of chemotherapy.

• Authors: Hadir A El-Mahallawy, Nelly H Aly El-Din, Fatma Salah, Maha El-Arousy, Sherif Abou El-Naga
• Journal: Pediatric blood & cancer (Pediatr Blood Cancer) Vol. 42 Issue 4 Pg. 338-42 (Apr 2004) ISSN: 1545-5009 [Print] United States
• PMID: 14966830 (Publication Type: Journal Article)
• Copyright: Copyright 2003 Wiley-Liss, Inc.

Chemical References

• Antineoplastic Agents

Topics

• Antineoplastic Agents (adverse effects, therapeutic use)
• Child
• Child, Preschool
• Diarrhea (etiology, microbiology)
• Gastroenteritis (epidemiology, etiology, microbiology)
• Humans
• Immunosuppression Therapy (adverse effects)
• Infections (epidemiology, etiology, microbiology)
• Neoplasms (complications, drug therapy, mortality)
• Regression Analysis
• Survival Rate
• Treatment Outcome