Incidence of septicaemias and invasive mycoses in children undergoing treatment for solid tumours: a 12-year experience at a single Italian institution

We carried out a retrospective study on the infection rate-in episodes per 100 person months at risk (p/m/r)-of septicaemia and invasive mycoses in ch ildren with solid tumours treated at a single institution between 1985 and 1996. Among 982 patients, accounting for 8108 p/m/r, 257 infectious episode s were documented, for an infection rate of 3.2. The infection rate for 'in tensive' treatment was greater than that for 'less intensive' treatments, 3 .7 compared with 0.5, respectively; P <0.001. 58% of infectious episodes we re associated with neutropenia, 22% were megatherapy-related, and 39% were related to central venous catheter (CVC), while in 13% of the episodes no r isk factor was identified. Of the episodes, single organism Gram-positive b acteraemias accounted for 62%, single organism Gram-negative for 23%, multi ple organism bacteraemias for 7%, invasive mycoses for 4%, and isolated fun gaemias for 4%. The infection rate for Gram-positive organisms decreased si gnificantly over time (-5.9% per year; P <0.01), but increased for the Gram -negative organisms (+3.4% per year; P = 0.4). This study demonstrates that the risk of bacteraemia increases in parallel with the treatment intensity , and that a considerable number of children with solid tumours develop bac teraemia in the absence of an identifiable risk factor. (C) 2001 Elsevier S cience Ltd. All rights reserved.