Investigation of seasonal frequency and pathogens in febrile neutropenia
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Summary
Background
In patients with hematological malignancies, febrile neutropenia (FEN) is the most frequent complication and the most important cause of mortality. Various risk factors have been identified for severe infection in neutropenic patients. However, to the best of our knowledge, it is not defined whether there is a change in the risk of febrile neutropenia according to seasons. The first aim of study was to determine the difference in frequency of febrile neutropenic episodes (FNEs) according to months and seasons. The second aim was to document isolated pathogens, as well as demographical and clinical characteristics of patients.
Methods
In the study, 194 FNEs of 105 patients who have been followed with hematological malignancies between June 2013 and May 2014 were evaluated retrospectively.
Results
Although the number of FNEs increased in autumn, there was no significant difference in frequency of FNEs between months (p = 0.564) and seasons (p = 0.345). There was no isolated pathogen in 54.6% of FNEs. In 45.4% of 194 FNEs, pathogens were isolated. Of all pathogens, 50.4% were gram negative bacteria, 29.2% were gram positive bacteria, 13.3% were viruses, 5.3% were fungi, and 1.8% were parasites.
Conclusıons
The frequency of FEN does not change according to months or seasons. Also, the relative proportions of different pathogens in the cause of FEN do not vary according to seasons.
Keywords
Neutropenia Fever Seasons Months HematologicalNotes
Acknowledgements
We are grateful to all treating physicians in our center for collaboration and data collection.
Conflict of interest
S.K. Özdemir, U. Iltar, O. Salim, O.K. Yücel, R. Erdem, Ö. Turhan, and L. Undar declare that they have no competing interests.
References
- 1.Kuderer NM, Dale DC, Crawford J, et al. Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer. 2006;106(10):2258–66.CrossRefGoogle Scholar
- 2.Freifeld AG, Bow EJ, Sepkowitz KA, et al. Infectious Diseases Society of Americaa. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2011;52(4):427–31.CrossRefGoogle Scholar
- 3.Pizzo PA. Management of fever in patients with cancer and treatment-induced neutropenia. N Engl J Med. 1993;328(18):1323–32. Review.CrossRefGoogle Scholar
- 4.Schimpff SC, Young VM, Greene WH, et al. Origin of infection in acute nonlymphocytic leukemia. Significance of hospital acquisition of potential pathogens. Ann Intern Med. 1972;77(5):707–14.CrossRefGoogle Scholar
- 5.Bodey GP, Jadeja L, Elting L. Pseudomonas bacteremia. Retrospective analysis of 410 episodes. Arch Intern Med. 1985;145(9):1621–9.CrossRefGoogle Scholar
- 6.Hughes WT, Armstrong D, Bodey GP, et al. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis. 2002;34(6):730–51.CrossRefGoogle Scholar
- 7.Wisplinghoff H, Seifert H, Wenzel RP, et al. Current trends in the epidemiology of nosocomial bloodstream infections in patients with hematological malignancies and solid neoplasms in hospitals in the United States. Clin Infect Dis. 2003;36(9):1103–10. Epub 2003 Apr 14.CrossRefGoogle Scholar
- 8.Holland T, Fowler VG Jr, Shelburne SA 3rd. Invasive gram-positive bacterial infection in cancer patients. Clin Infect Dis. 2014;59(Suppl 5):S331–S4.CrossRefGoogle Scholar
- 9.Viscoli C, Castagnola E. Treatment of febrile neutropenia: what is new? Curr Opin Infect Dis. 2002;15(4):377–82. Review.CrossRefGoogle Scholar
- 10.Sipsas NV, Bodey GP, Kontoyiannis DP. Perspectives for the management of febrile neutropenic patients with cancer in the 21st century. Cancer. 2005;103(6):1103–13. Review.CrossRefGoogle Scholar
- 11.Lyman GH, Abella E, Pettengell R. Risk factors for febrile neutropenia among patients with cancer receiving chemotherapy: A systematic review. Crit Rev Oncol Hematol. 2014;90(3):190–9.CrossRefGoogle Scholar
- 12.Flowers CR, Seidenfeld J, Bow EJ, et al. Antimicrobial prophylaxis and outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2013;20;31(6):794–810.CrossRefGoogle Scholar
- 13.Cruciani M, Rampazzo R, Malena M, et al. Prophylaxis with fluoroquinolones for bacterial infections in neutropenic patients: a meta-analysis. Clin Infect Dis. 1996;23(4):795–805.CrossRefGoogle Scholar
- 14.Kirkpatrick GL. The common cold. Prim Care. 1996;23(4):657–75. Review.CrossRefGoogle Scholar
- 15.Heikkinen T, Järvinen A. The common cold. Lancet. 2003;361(9351):51–9.CrossRefGoogle Scholar