Title:Prevalence and Outcomes of Infections in Critically-ill Paediatric Oncology Patients: A Retrospective Observation Study
Volume: 21
Issue: 2
Author(s): Karen K.Y. Leung, Pak Leung Ho, Sally C.Y. Wong, Wilson Y.K. Chan and Kam Lun Ellis Hon*
Affiliation:
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong, China
Keywords:
Critical care, critical illness, haematology, infection, intensive care, oncology, paediatrics, stem cell transplantation.
Abstract:
Purpose: The survival of paediatric oncology patients has improved substantially in the
past decades due to advances in the field of oncology. Modern cancer treatments often come with
life-threatening complications, of which infection is one of the most common causes in this patient
population. This study aims to investigate the prevalence and outcomes of common infections
in haemato-oncology patients during their stay in paediatric intensive care unit (PICU) and
to identify any factors associated with these infections.
Methods: A retrospective observational study was conducted on all children with a haemato-oncology
diagnosis or who underwent haematopoietic stem cell transplantation (HSCT) and who were
admitted to the Hong Kong Children’s Hospital PICU over a one-year period. Infection characteristics
and patient outcomes were evaluated and compared between different sub-groups. Univariable
and multi-variable analyses were employed to identify risk factors associated with the development
of active infection.
Results: Forty-five (36.3%) of 124 critically ill haemato-oncology admissions to PICU were associated
with infections, of which 31 (25%) admissions involved bacterial infections, 26 (20.9%) involved
viral infections and 6 (4.8%) involved fungal infections. Bloodstream infection was the
most common type of infection. More than half (61.3%) of the bacterial infections were due to an
antibiotic-resistant strain. After adjusting for confounding variables, post-HSCT status and neutropenia
were significantly associated with active infections.
Conclusion: Infections in critically-ill haemato-oncological patients are associated with post haematopoietic
stem cell transplant status and neutropenia. Further study is warranted to review effective
strategies that may mitigate the likelihood of infection in this patient population.
