A study of bacteremia in febrile neutropenic patients at a tertiary-care hospital with special reference to anaerobes
- 88 Downloads
Patients with hematological malignancies who are receiving chemotherapy suffer prolonged periods of neutropenia, which leads to a greater risk of infection and mortality. A prospective study was conduced to determine the incidence of bacteremia in patients of hematological malignancies over a 2-yr period. A total of 119 episodes of febrile neutropenia occurred among 96 consecutive patients, of which 35 episodes were associated with bacteremia. Forty-four percent of the isolated bacteria were Gram-positive aerobes and 46% were Gram-negative aerobes. Staphylococcus aureus, Enterococcus spp., and Escherichia coli were the most common isolates. Gram-negative bacteremia was associated with a higher mortality. Anaerobes accounted for 4.4% of all isolates. The episodes of anaerobic bacteremia were polymicrobial and had a fatal outcome. A high incidence of antimicrobial resistance among aerobic and anaerobic bacteria was also recorded. Compared to previous years, a shift from a predominating Gram-negative to a Gram-positive etiology was noted. The initial empiric antibiotic regimens should be based on a local knowledge of the most common causative microorganisms, their sensitivity pattern, and the outcome of bacteremia.
Key WordsBacteremia febrile neutropenia hematological malignancies anaerobes antimicrobial resistance
Unable to display preview. Download preview PDF.
- 2.Rolston, K.V. and Bodey, G.P. (1995). Infections in patients with cancer, in Cancer Medicine, 4th ed. (Holland, J.F., Bast, R.C., Morton, D.L., Frei, E., Kufe, D.W. and Weichselbaum, R.R., eds), pp. 3303–3333. Williams and Wilkins, Baltimore.Google Scholar
- 3.Freifeld, A.G., Walsh, T.J. and Philip, A. (1997). Infections in the cancer patient, in Cancer. Principles and Practice of Oncology, 5th ed. (DeVita, V.T., Jr, Hellman, S. and Rosenberg, S.A. eds), pp. 2659–2704, Lippincott-Raven New York.Google Scholar
- 4.Collee, J.G., Miles, R.S. and Watt, B. (1996). Tests for the identification of bacteria, in Mackie and McCartney. Practical Medical Microbiology. 14th ed. (Collee, J.G., Fraser, A.G., Marmion, B.P. and Simmons, A., eds), pp. 131–145, Churchill Livingstone, New York.Google Scholar
- 5.Forbes, B.A., Sahm, D.F. and Weissfeld, A.S. (1998). Bailey and Scott’s Diagnostic Microbiology, 10th ed. (Baron, E.J., Peterson, L.R., and Feingold, S.M., eds.), Mosby, St. Louis, MO.Google Scholar
- 6.Sutter, V.L., Citron, D.M., Finegold, S.M., et al. (1985). Wadworth Anaerobic Bacteriology Manual, 4th ed., Los Angeles, California.Google Scholar
- 7.Willis, A.T. (1960). Anaerobic Bacteriology in Clinical Medicine, Butterworth, London.Google Scholar
- 8.Miles, R.S. and Amyes, S.G.B. (1996). Laboratory control of antimicrobial therapy, in Mackie and McCartney. Practical Medical Microbiology, 14th ed. (Colle, J.G., Fraser, A.G., Marmion, B.P., and Simmons, A. eds), pp. 151–177, Churchill Livingstone, New York.Google Scholar