1233. Respiratory viral infections in children with cancer and febrile neutropenia episodes
Session: Poster Abstract Session: RSV and Other Viral Respiratory Infections in Children
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • 1233_JuanPabloTorres.pdf (712.8 kB)
  • Background: The role of respiratory viral infections (RVI) and their clinical relevance in febrile neutropenia (FN) episodes in children with cancer has not been systematically studied.  We conducted a 15 month follow-up study with the aim to determine clinical and laboratory characteristics of RVI during episodes of FN in children with cancer and describe viral-bacterial co-infections and bacterial infections in this group of patients.

    Methods: A prospective, multicenter, government sponsored study (FONDECYT 11080113) was done in children with cancer admitted with FN in the 3 main pediatric hospitals in Chile from May 2009 to July 2010. Clinical and laboratory evaluation plus conventional microbiological study were made for each episode until discharge. A nasopharyngeal sample was assessed for 17 respiratory viruses by PCR-Microarray platform (Pneumovir®, Genomica).

    Results: 189 episodes of FN in 158 children were enrolled. Most children were girls (57%), median age was 8 years (IQ 4-12) and 71% has a haematological malignancy. RVI was detected in 93/189 episodes (49%); 54/93 with 1 respiratory virus detected, 13/93 ≥2 respiratory viruses detected and 26/93 with respiratory viral-bacterial detection. A bacterial infection was detected in 42/189 (22%) of FN episodes. RSV was the respiratory virus most frequently detected (39/112 total respiratory viral detections;35%), followed by rhinovirus (25%), parainfluenza (12%), influenza A (12%), bocavirus (8%), adenovirus (4%) and hMPV (3%). Detection of RVI in patients with low and high risk for invasive bacterial infection (IBI) was not statistical different (33 vs 25% respectively>0.05). Days of fever, hypotension, PICU admission, hospitalization days and days of neutropenia after admission was significantly higher in bacterial group compared with RVI group (p<0.05).  All children with detection of RVI, without bacterial detection, had favorable outcome.

    Conclusion: RVI were the main detected agents in FN episodes of this study, including high and low risk of IBI groups. More studies are needed to characterize respiratory viral co-infections and viral-bacterial co-infections. Early and systematic study of RVI can help to optimize the management of FN episodes in children with cancer.


    Subject Category: P. Pediatric and perinatal infections

    Juan Pablo Torres, MD, PhD1, Mauricio Farfan, PhD1, Verónica De la Maza, RN1, Ivonne Vergara, Bq2, Paula Piemonte, MD2, Milena Villarroel, MD3, Marcela Zubieta, MD1, Juan Tordecilla, MD1 and María Elena Santolaya, MD4, (1)Universidad de Chile, Santiago, Chile, (2)Clínica Las Condes, Santiago, Chile, (3)Oncology Unit, Hospital Luis Calvo Mackenna, Santiago, Chile, (4)Pediatric Infectious Diseases, Universidad de Chile, Santiago, Chile

    Disclosures:

    J. P. Torres, None

    M. Farfan, None

    V. De la Maza, None

    I. Vergara, None

    P. Piemonte, None

    M. Villarroel, None

    M. Zubieta, None

    J. Tordecilla, None

    M. E. Santolaya, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.