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: The prevalence of Autoimmune Hemolytic Anemia (AIHA) globally ranges from 5-30%, but relatively high in Asia, 22%. This condition is commonly found among patients with thalassemia. However, no data are available about this disease in Lao PDR. Objective: To determine the proportion of AIHA among Lao children with thalassemia. Methodology: A cross-sectional study was conducted from May to September 2018 in pediatric patients with thalassemia who received blood transfusion at the Children’s Hospital, Vientiane Capital. There were 338 patients included in the study. Data analysis was done using SPSS, and Pearson chi-square was used to compare the two proportions. Finding: We found that the proportion of AIHA was 3.6% (12/336) amongst those with thalassemia with more males than females (3:1). The mean (SD) age was 11.5 ± 3 years old. The older age of patients was significantly associated with AIHA, p=0.001. We also found that patients with transfusion dependent thalassemia were more likely to have AIHA than those who were not. The mean reticulocyte count (%) was significantly higher in patients with AIHA than those without AIHA (8.61±10.57 versus 1.18±1.14, p<0.001). Other variables such as sex, type of thalassemia, age at diagnosis, the frequency of blood transfusion, age at first blood transfusion, blood group and hemoglobin before blood transfusion were not significantly associated with AIHA. Conclusion The proportion of AIHA remains low in Lao children with transfusion dependent thalassemia, but requires further attention to reduce its complications. There is a need to identify factors associated with AIHA among Lao patients with Transfusion Dependent Thalassemia