Neutropénie fébrile chimio-induite : expérience d'un centre d'hématologie et d'oncologie pédiatrique Chemotherapy-induced febrile neutropenia: experience of Pediatric Hematology and Oncology Center

Infections are a major cause of morbidity and mor- tality in children with neutropenia caused by chemotherapy. The aim of this study was to determine the epidemiological, clinical, microbiological, therapeutic, and evolutionary cha- racteristics for episodes of febrile neutropenia (FN). We report the results of a prospective study of episodes of FN in children followed at the Pediatric Hematology and Onco- logy Centre of Rabat (CHOP) for six months from June to December 2011. Fifty-one children had 76 episodes of FN. The median age was 78 months. The underlying cancer was dominated by hematological malignancies in 76.2%. The median time to onset of FN was 11.5 days. The median duration of neutropenia was 8 days. The infection was microbiologically documented in 25.6%. The germs found were Escherichia coli BLSE, Staphylococcus aureus, Pseu- domonas aeruginosa, Staphylococcus hemolyticus, White Staphylococcus, and Candida. The outcome was favorable in 88.5%. The treatment consisted of ceftazidime and amikacine in 42.2%, and the effective combination of a gly- copeptide in 12.8%. The addition of imipineme was neces- sary in 11.5%, and antifungals were used in 21.7%. The application of a treatment protocol tailored to the bacterial ecology of each unit is required without forgetting the means of prevention.