4B. Biomarkers for early detection of bacterial infection in children with cancer

Children with cancer are at risk for severe bacterial infections due to their disease and its treatment. Therefore, the international standard is to start empiric broad spectrum antibiotics in all patients presenting with fever during neutropenia. However, only 25% of these patients have an actual bacterial infection, while the other 75% has other causes of fever, not needing antibacterial treatment. This causes unnecessary antibiotic treatment potentially causing resistance and unnecessary hospital admissions, and decreased quality of life. On the other hand, infections are still an important cause of mortality, and early detection / prediction of bacterial infections might potentially prevent mortality.

In this project we aim to predict invasive bacterial infections based on changes in the faecal microbiome. For this we are recruiting a cohort of children with AML and Burkitt lymphoma, at high risk for bacterial infections. Using classical methodologies to study the microbiome (sequencing), but also newer techniques like e-nose and metabolomics, we will study if we can be able to predict who is at risk to develop a bacterial infection, in the end to be able to start pre-emptive, more directed, antibiotics.

Secondly, we aim to find biomarkers to be able to predict at presentation with fever who will have a bacterial infection and need antibiotics, and who has no bacterial infection, and does not need antibiotics and hospital admission. In an earlier trial we were able to prevent hospitalisation in 20% of the patients. In the next study we will try to increase this number, preventing unnecessary hospitalisation and increase quality of life.

Necessary skills for this position:

• Medical degree or relevant biomedical Master’s degree
• Sufficient knowledge of Dutch language or willingness to learn Dutch