Predictors and outcomes of viridans group streptococcal infections in pediatric acute myeloid leukemia: From the Canadian infections in AML research group

Victor Lewis, Rochelle Yanofsky, David Mitchell, David Dix, Marie Chantal Ethier, Biljana Gillmeister, Donna Johnston, Bruno Michon, Kent Stobart, Carol Portwine, Mariana Silva, Sonia Cellot, Victoria Price, Lynette Bowes, Shayna Zelcer, Josee Brossard, Joseph Beyene, Lillian Sung

Résultat de recherche: Articleexamen par les pairs

34 Citations (Scopus)

Résumé

BACKGROUND:: Viridans group streptococci (VGS) cause significant morbidity in children treated for acute myeloid leukemia (AML). Our goals were to determine the occurrence and impact of these infections in children treated for AML and to understand the factors that increase the risk of VGS infections and viridans streptococcal shock syndrome (VSSS) in this population. METHODS:: We conducted a retrospective, population-based cohort study that included children ≤18 years of age with de novo AML treated at 15 Canadian centers. We evaluated factors related to VGS infection and VSSS. RESULTS:: Among 341 children with AML, VGS occurred in 78 (22.9%) children over the entire course of therapy and 16 had recurrent episodes. VGS infection occurred in 97 of 1277 courses of chemotherapy (7.6%). VSSS occurred in 19.6% of these episodes and included 11 patients who required intensive care services with 2 VGS infections resulting in death. In multiple regression analysis, factors independently related to VGS included treatment on a Medical Research Council-based protocol (odds ratio (OR) 2.87, 95% confidence interval (CI) 1.53-5.39; P = 0.001), cytarabine dose per gram/m (OR 1.04, 95% CI 1.01-1.07; P = 0.002) and prolonged neutropenia (OR 1.58, 95% CI: 0.97-2.56; P = 0.06). None of the evaluated factors were predictive of VSSS. CONCLUSIONS:: VGS infections occur in 7.6% of chemotherapy courses and remain an important cause of morbidity and even mortality in children being treated for AML. Interventions to reduce VGS need to be identified.

Langue d'origineEnglish
Pages (de-à)126-129
Nombre de pages4
JournalPediatric Infectious Disease Journal
Volume33
Numéro de publication2
DOI
Statut de publicationPublished - 2014
Publié à l'externeOui

ASJC Scopus Subject Areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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