Bacterial Detection in Paediatric Cancer Patients with Febrile Neutropenia, From Conventional Microbiological Testing to Advanced Molecular Techniques: A Scoping Review Protocol

Objective: The objective of this scoping review is to understand the extent and type of evidence in relation to bacterial diagnostic approaches in paediatric cancer patients with febrile neutropenia (FN), with the goals of highlighting the best practice approach to conventional microbiological testing used in current clinical practice and explore the role of emerging technologies as potential diagnostic tools. Introduction: FN is a common complication for children undergoing chemotherapy for cancer, with bacterial bloodstream infection responsible for the majority of serious adverse events. Current diagnostic approaches have limited sensitivity and long turnaround times. Improved diagnostics are required to strengthen clinical decision rules and support the safer use of reduced-intensity management pathways. Eligibility Criteria: Children up to their 18th birthday with a diagnosis of cancer will be included, looking at bacterial diagnostic methods used in the evaluation of FN. Studies conducted across all healthcare settings will be considered. Studies focusing exclusively on viral or fungal diagnostics will be excluded, as will those not involving human participants. Methods: The review will be conducted in accordance with Joanna Briggs Institute and PRISMA-Scoping Review methodology. A comprehensive search of MEDLINE, Embase, Web of Science Core Collection and grey literature will be conducted to identify published and unpublished studies from 2011 onwards, with no language restrictions. Primary research studies of any design will be included, however case reports with fewer than 10 participants will be excluded. Two independent reviewers will screen studies and extract data. Any discrepancies will be resolved by consensus, involving a third reviewer if necessary. Findings will be synthesised and presented using tables and figures, accompanied by a narrative synthesis to address the research question.