Background: : Cancer patients with febrile neutropenia (FN) at risk of life-threatening sepsis, and require immediate empirical antibiotic therapy. Appropriate empirical therapy is a key factor for the management. 48% to 60% of childhood cancer patients with FN have infections. Bacteremia was found in 10-50% of all patients with febrile neutropenia. Objective: : To investigate the causative bacteremia Pathogens in children with cancer during febrile neutropenia at children hospital, Vientiane, Lao PDR. Methods: : A cross-sectional descriptive study was conducted to investigate the bacterial pathogens responsible for febrile neutropenia (FN) in children under 15 years of age undergoing chemotherapy for cancer. The study was carried out at the Department of Pediatric Hemato-oncology, Children's Hospital, Vientiane, Laos, from October 2021 to September 2022. Results: : A prospective study involving 162 FN episodes was undertaken. The most prevalent underlying malignancy was acute lymphoblastic leukemia (ALL), accounting for (78.40%) of cases. Clinical presentations associated with FN included pneumonia 21%. Febrile neutropenia without an identified source accounted for 58.02% of FN episodes. Severe neutropenia was observed in 59.88% of FN episodes. The frequency of bacteremia was 19.14%. Gram-negative organisms constituted 83.87% of infections, with E. coli being the most frequently isolated pathogen 29.03%. Other gram-negative organisms included Klebsiella pneumoniae, Pseudomonas aeruginosa, Burkholderia pseudomallei, and Acinetobacter baumannii. Fifty percent of E. coli and K. pneumoniae exhibited extended-spectrum beta-lactamase (ESBL) production. All ESBL-producing organisms were susceptible to meropenem and amikacin. Gram-positive organisms accounted for 16.13% of infections, with methicillin-resistant Staphylococcus aureus (MRSA) being the most prevalent 6.45%. Half of the Gram-negative organisms showed sensitivity to ceftazidime, and they were all 100% sensitive to aminoglycosides, particularly amikacin and meropenem. Conclusion: Within the context of febrile neutropenia, the frequency of bacteremia was found to be 19.14%. The most common primary causative organism was E. coli. Based on these findings, we recommend that for low-risk patients with FN, the initial empiric antibiotic regimen should consist of ceftazidime and amikacin. For high-risk patients or those hospitalized for extended periods, the most suitable empiric antibiotic regimen is meropenem combined with amikacin.

Background: : Cancer is one of the leading causes of death in children. The incidence of cancer in children under the age of 15 year varies worldwide. Despite significant advances in the treatment and early detection, cancer is the second major cause of child mortality in developed world. In some developed countries such as Australia, Ireland, Switzerland and the United States, the incidence of childhood cancer has been estimated at 140 - 160 per 1 million children. Objectives: : To determine the outcomes of induction treatment in childhood acute lymphoblastic leukemia at Children Hospital, Vientiane Capital, Lao PDR. Methodology:: A prospective descriptive study at Hematology - Oncology department, Children hospital, in Vientiane Capital, Laos.From December 2021 to November 2022. The include criteria was the newly acute lymphoblastic leukemia who received chemotherapy treatment during induction phase. The descriptive statistic was analyzed with SPSS version 26 and reported by table, chart with frequency Results: : A total participants 36 newly acute lymphoblastic leukemia including the male was higher the female, the clinical profile showed fever and pale were most common, during the induction were including the complication of specific treatment and supportive treatment. Seven (19.4%) patients died due to infection the pathogen of hemoculture were acetobacter, klebsiella pneumonia, pseudomonas aeruginosa and ESBL, bleeding and tumor lysis syndrome during the course of induction therapy. After induction therapy twenty-two (61.1%) patients went into the complete remission (<5%blast cells in bone marrow), five patients (13.9%) was not in remission (>5%blast cells in the bone marrow).Seven (19.4%) patients died and 2 patients were refuse of treatment including the problem of financial and family. Conclusion: The rate of complete remission of induction therapy and death during induction therapy of the outcome in acute lymphoblastic leukemia was high, the male of remission is higher than female and the most classification of risk group was high risk group. The feature of clinical acute lymphoblastic leukemia paediatric was fever and pallor. The majority cause of death is infection.