Clinical factors predicting bacteremia in low-risk febrile neutropenia after anti-cancer chemotherapy.

Abstract

PURPOSE:

Bacteremia is an important clinical condition in febrile neutropenia that can cause clinical failure of antimicrobial therapy. The purpose of this study was to investigate the clinical factors predictive of bacteremia in low-risk febrile neutropenia at initial patient evaluation.

METHODS:

We performed a retrospective cohort study in a university hospital in Seoul, Korea, between May 1995 and May 2007. Patients who met the criteria of low-risk febrile neutropenia at the time of visit to emergency department after anti-cancer chemotherapy were included in the analysis.

RESULTS:

During the study period, 102 episodes of bacteremia were documented among the 993 episodes of low-risk febrile neutropenia. Single gram-negative bacteremia was most frequent. In multivariate regression analysis, initial body temperature ≥39°C, initial hypotension, presence of clinical sites of infection, presence of central venous catheter, initial absolute neutrophil count <50/mm(3), and the CRP ≥10 mg/dL were statistically significant predictors for bacteremia. A scoring system using these variables was derived and the likelihood of bacteremia was well correlated with the score points with AUC under ROC curve of 0.785. Patients with low score points had low rate of bacteremia, thus, would be candidates for outpatient-based or oral antibiotic therapy.

CONCLUSIONS:

We identified major clinical factors that can predict bacteremia in low-risk febrile neutropenia.

• Authors: Young Eun Ha, Jae-Hoon Song, Won Ki Kang, Kyong Ran Peck, Doo Ryeon Chung, Cheol-In Kang, Mi-Kyong Joung, Eun-Jeong Joo, Kyung Mok Shon
• Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Support Care Cancer) Vol. 19 Issue 11 Pg. 1761-7 (Nov 2011) ISSN: 1433-7339 [Electronic] Germany
• PMID: 20931237 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents (adverse effects, therapeutic use)
• Bacteremia (epidemiology)
• Cohort Studies
• Female
• Fever (etiology, microbiology)
• Humans
• Likelihood Functions
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasms (drug therapy)
• Neutropenia (etiology, microbiology)
• ROC Curve
• Regression Analysis
• Republic of Korea
• Retrospective Studies
• Young Adult