Table 2. Distribution of Gram-negative and Gram-positive bloodstream isolates in pediatric patients with AML treated in the (a) standard-risk (SR) or (b) high-risk (HR) group according to chemotherapy.
|
(a) | |||||||
|---|---|---|---|---|---|---|---|
| Patients of SR group | Total |
Neutrophils/μl |
Induction | AI | haM | HAE | |
| <500 | >500 | ||||||
| All | 87 (100%) | 62 (71.3) | 25 (28.7) | 18 (20.7) | 13 (14.9) | 28 (32.2) | 28 (32.2) |
| Gram positive | 65 (74.7) | 48 (55.2) | 17 (19.5) | 15 (17.2) | 13 (14.9) | 19 (21.8) | 18 (20.7) |
| Staphylococci | |||||||
| All | 16 (18.4) | 12 (13.8) | 4 (4.6) | 6 (6.9) | 5 (5.7) | 3 (3.4) | 2 (2.3) |
| CoNS | 12 (13.8) | 9 (10.3) | 3 (3.4) | 6 (6.9) | 3 (3.4) | 2 (2.3) | 1 (1.1) |
| Staphylococcus aureus | 1 (1.1) | 0 | 1 (1.1) | 0 | 0 | 1 (1.1) | 0 |
| Streptococci | |||||||
| All | 37 (42.5) | 31 (35.6) | 6 (6.9) | 5 (5.7) | 6 (6.9) | 13 (14.9) | 13 (14.9) |
| VGS | 33 (37.9) | 28 (32.2) | 5 (5.7) | 4 (4.6) | 6 (6.9) | 13 (14.9) | 10 (11.5) |
| Enterococcus spp. | 1 (1.1) | 0 (0) | 1 (1.1) | 0 | 1 (1.1) | 0 | 0 |
| Micrococcus spp. | 6 (6.9) | 2 (2.3) | 4 (4.6) | 3 (3.4) | 1 (1.1) | 1 (1.1) | 1 (1.1) |
| Othera | 5 (5.7) | 3 (3.4) | 2 (2.3) | 1 (1.1) | 0 | 2 (2.3) | 2 (2.3) |
| Gram-negative | 22 (25.3) | 14 (16.1) | 8 (9.2) | 3 (3.4) | 0 | 9 (10.3) | 10 (11.5) |
| Klebsiella spp. | 5 (5.7) | 5 (5.7) | 0 | 1 (1.1) | 0 | 1 (1.1) | 3 (3.4) |
| Pseudomonas aeruginosa | 2 (2.3) | 1 (1.1) | 1 (1.1) | 1 (1.1) | 0 | 1 (1.1) | |
| Escherichia coli | 9 (10.3) | 8 (9.2) | 1 (1.1) | 0 | 0 | 2 (2.3) | 7 (8.0) |
| Enterobacter spp. | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Acinetobacter spp. | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Otherb | 6 (6.9) | 0 | 6 (6.9) | 1 (1.1) | 0 | 5 (5.7) | 0 |
|
(b) | ||||||||
|---|---|---|---|---|---|---|---|---|
| Patients of HR group | Total |
Neutrophils/μl |
Induction | HAM | Consolidation | haM | HAE | |
| <500 | >500 | |||||||
| All | 243 (100%) | 176 (72.4) | 67 (27.6) | 37 (15.2) | 29 (11.9) | 64 (26.3) | 55 (22.6) | 58 (23.9) |
| Gram positive | 175 (72.0) | 118 (48.6) | 57 (23.5) | 29 (11.9) | 24 (9.9) | 43 (17.7) | 39 (16.0) | 40 (16.5) |
| Staphylococci | ||||||||
| All | 54 (22.2) | 27 (11.1) | 27 (11.1) | 11 (4.5) | 10 (4.1) | 10 (4.1) | 12 (4.9) | 11 (4.5) |
| CoNS | 41 (16.9) | 21 (8.6) | 20 (8.2) | 7 (2.9) | 8 (3.3) | 10 (4.1) | 10 (4.1) | 6 (2.5) |
| S. aureus | 5 (2.1) | 1 (0.4) | 4 (1.6) | 1 (0.4) | 0 | 0 | 1 (0.4) | 3 (1.2) |
| Streptococci | ||||||||
| All | 93 (38.3) | 68 (19.8) | 25 (10.3) | 12 (4.9) | 12 (4.9) | 22 (9.1) | 23 (9.5) | 24 (9.9) |
| VGS | 79 (32.5) | 54 (22.2) | 25 (10.3) | 11 (4.5) | 8 (3.3) | 20 (8.2) | 18 (7.4) | 22 (9.1) |
| Enterococcus spp. | 5 (2.1) | 4 (1.6) | 1 (0.4) | 2 (0.8) | 0 | 2 (0.8) | 0 | 1 (0.4) |
| Micrococcus spp. | 8 (3.3) | 6 (2.5) | 2 (0.8) | 1 (0.4) | 1 (0.4) | 3 (1.2) | 0 | 3 (1.2) |
| Otherc | 15 (6.2) | 13 (5.3) | 2 (0.8) | 3 (1.2) | 1 (0.4) | 6 (2.5) | 4 (1.6) | 1 (0.4) |
| Gram-negative | 68 (28.0) | 58 (23.9) | 10 (4.1) | 8 (3.3) | 5 (2.1) | 21 (8.6) | 16 (6.6) | 18 (7.4) |
| Klebsiella spp. | 10 (4.1) | 9 (3.7) | 1 (0.4) | 0 | 0 | 5 (2.1) | 1 (0.4) | 4 (1.6) |
| P. aeruginosa | 16 (6.6) | 14 (5.8) | 2 (0.8) | 2 (0.8) | 2 (0.8) | 4 (1.6) | 4 (1.6) | 4 (1.6) |
| E. coli | 23 (9.5) | 20 (8.2) | 3 (1.2) | 4 (1.6) | 0 | 8 (3.3) | 5 (2.1) | 6 (2.5) |
| Enterobacter spp. | 9 (3.7) | 8 (3.3) | 1 (0.4) | 0 | 1 (0.4) | 1 (0.4) | 5 (2.1) | 2 (0.8) |
| Acinetobacter spp. | 2 (0.8) | 2 (0.8) | 0 (0.0) | 0 | 1 (0.4) | 0 | 0 | 1 (0.4) |
| Otherd | 8 (3.3) | 5 (2.1) | 3 (1.2) | 2 (0.8) | 1 (0.4) | 3 (1.2) | 1 (0.4) | 1 (0.4) |
Abbreviations: AML, acute myeloid leukemia; CoNS, coagulase-negative staphylococci; VGS, viridans group streptococci.
Polymicrobial bacteremia was seen in 8 patients (7 patients with 2 pathogens, 1 patient with 3 pathogens) in the SR group, and in 11 patients (9 patients with 2 pathogens, 2 patients with 3 pathogens) in the HR group.
For specification of chemotherapy see text.
Includes Gemella morbillorum (n=1), Gram-positive cocci (3) and Gram-positive rods (1).
Includes Gram-negative cocci (1) and Gram-negative rods (5).
Includes Gemella morbillorum (1), Gram-positive cocci (10) and Gram-positive rods (4).
Includes Serratia marrescens (1), Salmonella spp. (2), Stenotrophomonas maltophilia (1), Gram-negative cocci (1) and Gram-negative rods (4).