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Morales-Ríos O, Cicero-Oneto C, García-Ruiz C, Villanueva-García D, Hernández-Hernández M, Olivar-López V, Jiménez-Juárez RN, Jasso-Gutiérrez L. Descriptive study of adverse drug reactions in a tertiary care pediatric hospital in México from 2014 to 2017. PLoS One 2020; 15:e0230576. [PMID: 32208451 PMCID: PMC7092985 DOI: 10.1371/journal.pone.0230576] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 03/03/2020] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION In Pediatrics, adverse drug reactions (ADRs) affect morbidity and mortality. In Mexico, the characteristics of ADRs and suspect drugs have not been described in hospitalized children. OBJECTIVE To estimate the frequency of ADRs and describe them, as well as suspect drugs, in a tertiary care pediatric hospital in Mexico. METHODS A total of 1,649 Hospital Infantil de Mexico Federico Gómez ADR reports were analyzed. Completeness of the information was assessed, and ADRs severity and seriousness were assigned based on NOM-220-SSA1-2012, with causality being established according to the Naranjo algorithm. ADRs were classified with WHO Adverse Drug Reaction Terminology (WHO-ART). The drugs involved in ADRs were categorized according to the Anatomical Therapeutic Chemical (ATC) classification. Descriptive analysis was performed using the SPSS 20 statistical package. RESULTS Of all the reports, 5.8% lacked sufficient information for the analysis (grade 0). ADRs frequency ranged from 2.12% to 8.07%. ADRs occurred most commonly in children (56.9%), in the female gender (52%), in subjects with normal BMI Z-score (46.6%) and malnutrition (35.3%), diagnosed with neoplasms (72.2%) and in the Emergency Department (70.0%). ADRs were severe in 14.4% of cases, in 81.0% they were serious and 2.1% were classified as definite. Most common serious ADR was febrile neutropenia (44.5%). The 0.7% of patients recovering with sequelae; 1.1% died (with the medication being associated) and 70.3% were admitted to the hospital as a result of an ADR. Antineoplastic and immunomodulating agents were more commonly associated with serious ADRs. CONCLUSION ADRs affected morbidity and mortality, which is why strengthening pharmacovigilance programs in Mexican pediatric hospitals is necessary.
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Affiliation(s)
- Olga Morales-Ríos
- Clinical Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Carlo Cicero-Oneto
- Hematological Oncology Department, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Carlos García-Ruiz
- Clinical Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Dina Villanueva-García
- Neonatology Department, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | | | - Víctor Olivar-López
- Emergency Department, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Rodolfo Norberto Jiménez-Juárez
- Infectious Diseases Department, Hospital Infantil de México Federico Gómez, Ciudad de México, México
- Department of Pediatrics, Centro Médico Nacional La Raza, Infectious Diseases Hospital, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Luis Jasso-Gutiérrez
- Clinical Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, México
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Tural Kara T, Erat T, Yahşi A, Özdemir H, İleri T, İnce E, Taçyıldız N, Ünal E, Çiftçi E, İnce E. Bloodstream infections in pediatric hematology/oncology patients: Six years’ experience of a single center in Turkey. Turk J Med Sci 2019; 49:1157-1164. [PMID: 31342734 PMCID: PMC7018311 DOI: 10.3906/sag-1812-101] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background/aim Bloodstream infections are the major cause of morbidity, increased cost, prolonged hospitalization, and mortality in pediatric patients. Identifying the predominant microorganisms and antimicrobial susceptibilities in centers helps to select effective empirical antimicrobials which leads to positive clinical outcomes. We aimed to identify the causative microorganisms and their antimicrobial susceptibilities in patients with bloodstream infections. Materials and methods Data belonging to patients with hematological and/or oncological diseases admitted to our hospital with fever between January 2010 and November 2015 were analyzed. Results In total, 71 patients who had 111 bloodstream infection episodes were included. Responsible pathogens were detected as follows: 35.1% gram-positive microorganisms, 60.5% gram-negative bacteria, and 4.4% fungi. The most common causative gram-negative pathogen was Escherichia coli and the most commonly isolated gram-positive microorganism was coagulase-negative staphylococci. Conclusion Gram-negative microorganisms were predominant pathogens in bloodstream infections. Escherichia coli and coagulase-negative staphylococci were the most commonly isolated responsible pathogens. Beta-lactam/lactamase inhibitors were suitable for empirical treatment. However, in critical cases, colistin could have been used for empirical treatment until the culture results were available. Routine glycopeptide use was not required. By identifying the causative microorganisms and their antimicrobial resistance patterns, it will be possible to obtain positive clinical results.
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Affiliation(s)
- Tuğçe Tural Kara
- Department of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Tuğba Erat
- Department of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Aysun Yahşi
- Department of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Halil Özdemir
- Department of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Talia İleri
- Department of Pediatric Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Elif İnce
- Department of Pediatric Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Nurdan Taçyıldız
- Department of Pediatric Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emel Ünal
- Department of Pediatric Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ergin Çiftçi
- Department of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Erdal İnce
- Department of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
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Vázquez-López R, Rivero Rojas O, Ibarra Moreno A, Urrutia Favila JE, Peña Barreto A, Ortega Ortuño GL, Abello Vaamonde JA, Aguilar Velazco IA, Félix Castro JM, Solano-Gálvez SG, Barrientos Fortes T, González-Barrios JA. Antibiotic-Resistant Septicemia in Pediatric Oncology Patients Associated with Post-Therapeutic Neutropenic Fever. Antibiotics (Basel) 2019; 8:E106. [PMID: 31366110 PMCID: PMC6783913 DOI: 10.3390/antibiotics8030106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/15/2019] [Accepted: 07/17/2019] [Indexed: 12/13/2022] Open
Abstract
Death in cancer patients can be caused by the progression of tumors, their malignity, or other associated conditions such as sepsis, which is a multiphasic host response to a pathogen that can be significantly amplified by endogenous factors. Its incidence is continuously rising, which reflects the increasing number of sick patients at a higher risk of infection, especially those that are elderly, pediatric, or immunosuppressed. Sepsis appears to be directly associated with oncological treatment and fatal septic shock. Patients with a cancer diagnosis face a much higher risk of infections after being immunosuppressed by chemotherapy, radiotherapy, or anti-inflammatory therapy, especially caused by non-pathogenic, Gram-negative, and multidrug-resistant pathogens. There is a notorious difference between the incidence and mortality rates related to sepsis in pediatric oncologic patients between developed and developing countries: they are much higher in developing countries, where investment for diagnosis and treatment resources, infrastructure, medical specialists, cancer-related control programs, and post-therapeutic care is insufficient. This situation not only limits but also reduces the life expectancy of treated pediatric oncologic patients, and demands higher costs from the healthcare systems. Therefore, efforts must aim to limit the progression of sepsis conditions, applying the most recommended therapeutic regimens as soon as the initial risk factors are clinically evident-or even before they are, as when taking advantage of machine learning prediction systems to analyze data.
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Affiliation(s)
- Rosalino Vázquez-López
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Cuidad de México 52786, Mexico.
| | - Omar Rivero Rojas
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Cuidad de México 52786, Mexico
| | - Andrea Ibarra Moreno
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Cuidad de México 52786, Mexico
| | - José Erik Urrutia Favila
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Cuidad de México 52786, Mexico
| | - Adan Peña Barreto
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Cuidad de México 52786, Mexico
| | - Guadalupe Lizeth Ortega Ortuño
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Cuidad de México 52786, Mexico
| | - Jorge Andrés Abello Vaamonde
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Cuidad de México 52786, Mexico
| | - Ivanka Alejandra Aguilar Velazco
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Cuidad de México 52786, Mexico
| | - José Marcos Félix Castro
- Coordinación Ciclos Clínicos, Facultad de Ciencias de la Salud, Universidad Anáhuac México Campus Norte, Cuidad de México 52786, Mexico
| | - Sandra Georgina Solano-Gálvez
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | - Tomás Barrientos Fortes
- Director Facultad de Ciencias de la Salud, Universidad Anáhuac México, Cuidad de México 52786, Mexico
| | - Juan Antonio González-Barrios
- Laboratorio de Medicina Genómica, Hospital Regional "Primero de Octubre", ISSSTE, Av. Instituto Politécnico Nacional 1669, Lindavista, Gustavo A. Madero, Ciudad de Mexico 07300, Mexico
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Töret E, Karapınar T, Bulut M, Aksay A, Ay Y, Oymak Y, Devrim İ, İnce D. Kanserli Çocuklarda Febril Nötropeni Ataklarının İncelenmesi. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2018. [DOI: 10.17944/mkutfd.489213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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