@article{3034702,
    title = "Predictive Factors for Gram-negative Versus Gram-positive Bloodstream
Infections in Children With Cancer",
    author = "Sfetsiori, Angeliki-Eleni and Doganis, Dimitrios and Doudoulakakis, and Anastasios and Spyridis, Nikolaos and Pourtsidis, Apostolos and and Servitzoglou, Marina and Nikita, Maria and Papachristidou, Smaragda and and Magkou, Evgenia and Dana, Helen and Lebessi, Evangelia and Kosmidis, and Helen and Baka, Margarita and Tsolia, Maria",
    journal = "Journal of Pediatric Hematology / Oncology",
    year = "2022",
    volume = "44",
    number = "2",
    pages = "E368-E373",
    publisher = "Lippincott, Williams & Wilkins",
    issn = "1077-4114, 1536-3678",
    doi = "10.1097/MPH.0000000000002253",
    keywords = "Gram; bloodstream infection; predictive; risk factors",
    abstract = "Background: Identifying potential predictive factors for the type of
bacteremia (Gram-negative vs. Gram-positive) in children with cancer
would be crucial for the timely selection of the appropriate empiric
antibiotic treatment. Materials and Methods: Demographic, clinical, and
laboratory characteristics of children with cancer and a bacterial
bloodstream infection (BSI) (February 1, 2011 to February 28, 2018) in a
tertiary pediatric oncology department were retrospectively examined and
were correlated with the type of isolated bacteria. Results: Among 224
monomicrobial bacterial BSI episodes, Gram-negative and Gram-positive
bacteria were isolated in 110 and 114 episodes, respectively.
Gram-negative bacteria were isolated significantly more frequently in
girls (Gram-negative/Gram-positive ratio 1.7:1) versus boys
(Gram-negative/Gram-positive ratio 0.72:1), P=0.002, in patients with
previous BSI episodes (1.4:1) versus those without (0.8:1), P=0.042, and
in children with hematologic malignancy (1.3:1) versus those who
suffered from solid tumors (0.52:1), P=0.003. Gram-negative BSI episodes
were more frequently correlated with a lower count of leukocytes,
P=0.009, neutrophils, P=0.009 and platelets, P=0.002, but with
significantly higher C-reactive protein (CRP) levels, P=0.049. Female
sex, hematologic malignancy, and higher CRP levels remained independent
risk factors for Gram-negative BSI in the multivariate analysis. Among
neutropenic patients, boys with solid tumors and a recent central venous
catheter placement appear to be at increased risk for Gram-positive BSI
in the multivariate analysis. Conclusions: Although Gram-negative and
Gram-positive BSIs are close to balance in children with cancer,
Gram-negative bacteria are more likely to be isolated in girls, children
with hematologic malignancies and those with higher CRP level at
admission. In contrast, neutropenic boys with solid tumors and a
recently placed central venous catheter may be at increased risk for
Gram-positive BSI indicating probably the need for initially adding
antibiotics targeting Gram-positive bacteria."
}