alexa Epidemiologic Profile of Symptomatic Gastroenteritis in Pediatric Oncology Patients Receiving Chemotherapy
Infectious Diseases

Infectious Diseases

Journal of Clinical Infectious Diseases & Practice

Author(s): ElMahallawy HA, ElDin NH, Salah F, ElArousy M, ElNaga SA

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BACKGROUND: Patients with cancer who receive intensive chemotherapeutic regimens are subject to profound immunosuppression and are susceptible to an extended array of pathogens. PROCEDURE: The infectious causes of symptomatic gastroenteritis as evidenced by diarrhea +/- fever, vomiting, and abdominal colic in children following chemotherapy were prospectively monitored at National Cancer Institute, Cairo University. RESULTS: A total of 104 diarrhea episodes were recorded in our institution during a 10-month period, of which an infectious cause was detected in 74 (71.1%). Bacterial and fungal pathogens were isolated in culture from 41 (39.4%) and 24 (23.1%), respectively, while Clostridia difficile (C. difficile) and Cryptosporidium parvum (C. parvum) were detected in 15 (14.4%) and 10 (9.6%) of 104 diarrhea episodes following chemotherapy, respectively. Mixed infections were found in 24 of the patients; whereas, no cause was demonstrable in 30. Hospital acquired and mixed infections were the worst as regards morbidity (P = 0.004 and 0.02) and mortality (P = 0.007 and <0.001) of the infectious episode regardless the cause, respectively. On multivariate analysis, C. difficile was associated with the highest mortality rate (OR = 0.04, 95% CI = 0.01-0.19), followed by fungal pathogens (OR = 0.20, 95% CI = 0.05-0.74) and bacterial infections (OR = 0.20, 95% CI = 0.05-0.79). CONCLUSIONS: Infectious gastroenteritis is an important cause of morbidity and mortality in hospitalized pediatric cancer patients receiving intensified protocols of chemotherapy.

This article was published in Pediatric blood & cancer and referenced in Journal of Clinical Infectious Diseases & Practice

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