Prevalence of Fungemia in Pediatric Patients with Febrile Neutropenia

Document Type : Original Article


1 Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan; Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Increasing use of different chemotherapy regimens, organ transplants, etc., has led to the increasing number of neutropenic patients. Overall, 10% of patients affected by cancer who are under treatment with anticancer drugs, regardless of the tumor type, are susceptible to febrile neutropenia. The study was performed to evaluate the frequency of bloodstream fungal infections in pediatric patients with febrile neutropenia in Sayed Al-Shohada Hospital (Cancer Referral Center in Isfahan) in 2010–2012. Materials and Methods: This cross-sectional study was performed on pediatric patients with febrile neutropenia who were referred to Sayed Al-Shohada Hospital (Cancer Referral Center in Isfahan) in 2010–2012. Blood samples were obtained from all the patients and were loaded into Bactec 9050 blood culture instruments (Bectone Dickinson, Baltimore, Md., USA), and organisms responsible for causing fever were detected. Results: Sixty-seven patients (51.3 males, 48.7 females) with a mean age of 12.3 ± 15.8 years were included. The blood cultures of 48 patients (71.6%) were negative. Seven samples of the isolates (10.4%) were fungi, and twelve of them (18%) were bacteria. Thus, the prevalence of fungal infection was 10.4%. Conclusion: Due to the high relative prevalence of fungal infections in our study, it is necessary to take precautions for fungal infection prevention and choose the best way management to obtain optimal results in these patients.


Hughes WT, Armstrong D, Bodey GP, Bow EJ, Brown AE, Calandra T, et al. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis 2002;34:730-51.  Back to cited text no. 1
Ritchie S, Palmer S, Ellis-Pegler R. High-risk febrile neutropenia in Auckland 2003-2004: The influence of the microbiology laboratory on patient treatment and the use of pathogen-specific therapy. Intern Med J 2007;37:26-31.  Back to cited text no. 2
Vanderpuye V, Yarney J, Beecham K. Management of febrile neutropenia in patients receiving chemotherapy for solid tumors: A retrospective study of twenty cases from the radiotherapy centre, Accra, Ghana. West Afr J Med 2010;29:303-8.  Back to cited text no. 3
Gardner A. Diagnosing fungal infections in neutropenic patients. Clin J Oncol Nurs 2007;11:29-32.  Back to cited text no. 4
Sobel JD. Design of clinical trials of empiric antifungal therapy in patient's persistent febrile neutropenia: Considerations and critiques. Pharmacotherapy 2006;26(6 Pt 2):47S-54S.  Back to cited text no. 5
Saeidpour M, Hamedi AK, Hanachi P. Pattern of bacterial and fungal infections in neutropenic pediatric patients. Iran J Med Sci 2008;33:202-8.  Back to cited text no. 6
Fricker-Hidalgo H, Lebeau B, Pelloux H, Grillot R. Use of the BACTEC 9240 system with mycosis-IC/F blood culture bottles for detection of fungemia. J Clin Microbiol 2004;42:1855-6.  Back to cited text no. 7
Badiee P, Kordbacheh P, Alborzi A, Zakernia M, Haddadi P. Early detection of systemic candidiasis in the whole blood of patients with hematologic malignancies. Jpn J Infect Dis 2009;62:1-5.  Back to cited text no. 8
Mess T, Daar ES. Utility of fungal blood cultures for patients with AIDS. Clin Infect Dis 1997;25:1350-3.  Back to cited text no. 9
Meidani M, Rostami M, Moulaee S. Blood culture in neutropenic patients with fever. Int J Prev Med 2012;3:141-2.  Back to cited text no. 10
Meidani M, Bagheri A, Khorvash F. A population-based study of bacterial spectrum in febrile neutropenic patients. Jundishapur J Microbiol 2013;6:150-6.  Back to cited text no. 11