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

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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/mm3, 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.

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Acknowledgments

This study was supported by a grant of the Korea Healthcare Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A090764).

Conflict of interest statement

There is no financial conflict of interest.

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Authors and Affiliations

  1. Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea

    Young Eun Ha, Jae-Hoon Song, Kyong Ran Peck, Doo Ryeon Chung, Cheol-In Kang, Mi-Kyong Joung, Eun-Jeong Joo & Kyung Mok Shon

  2. Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Won Ki Kang

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  1. Young Eun Ha
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Correspondence to Young Eun Ha or Jae-Hoon Song.

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Ha, Y.E., Song, JH., Kang, W.K. et al. Clinical factors predicting bacteremia in low-risk febrile neutropenia after anti-cancer chemotherapy. Support Care Cancer 19, 1761–1767 (2011). https://doi.org/10.1007/s00520-010-1017-4

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  • DOI: https://doi.org/10.1007/s00520-010-1017-4

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