Clinical characteristics and microbiological profile of viridans group streptococci bacteremia in children with cancer and high-risk febrile neutropenia

• Published in: Revista chilena de infectología Vol. 37; no. 4; pp. 383 - 388
• Main Authors: Cortés, Daniel, Maldonado, María Eliana, Rivacoba, María Carolina, Maza, Verónica de la, Valenzuela, Romina, Payá, Ernesto, Contardo, Verónica, Álvarez, Ana María, Avilés, Carmen Luz, Becker, Ana, Salgado, Carmen, Tordecilla, Juan, Varas, Mónica, Venegas, Marcela, Villarroel, Milena, Viviani, Tamara, Zubieta, Marcela, Santolaya, María Elena
• Format: Journal Article
• Language: Spanish
• Published: Chile 01-08-2020
• Subjects: Anti-Bacterial Agents - therapeutic use; Bacteremia - drug therapy; Child; Chile - epidemiology; Febrile Neutropenia - drug therapy; Humans; Neoplasms - complications; Neoplasms - drug therapy; Prospective Studies; Streptococcal Infections - drug therapy; Chile
• ISSN: 0717-6341
• DOI: 10.4067/S0716-10182020000400383

Viridans group streptococci (VGS) has acquired relevance as a microorganism causing febrile neutropenia, associated with significant morbidity.
To characterize episodes of bacteremia caused by VGS in children with cancer who developed high-risk febrile neutropenia (HRFN) during the period from April 2004 to June 2018 in six pediatric hospitals of Santiago, Chile.
Database analysis of 4 successive, prospective and multicentric studies recording clinical and laboratory characteristics of patients, as well as antimicrobial susceptibility pattern of isolated strains.
95 episodes of VGS bacteremia in 91 children with HRFN were analyzed. It emphasizes acute myeloid leukemia as cancer type, deep neutropenia, prolonged hospitalization (15 days), with extended use of antimicrobials (14 days) and use of cytarabine in chemotherapy schemes (86% episodes). The most frequent clinical manifestations were respiratory and gastrointestinal, associating up to 26% viridans group shock syndrome. There was high resistance to β lactams. As expected, there were not non-susceptible strains to vancomycin.
VGS is a relevant microorganism in children with cancer, fever and neutropenia, with a high percentage of sepsis. Resistance to β lactams is an issue that requires strict epidemiological surveillance in this population.