Skip to main content
Log in

A study of bacteremia in febrile neutropenic patients at a tertiary-care hospital with special reference to anaerobes

  • Original Article
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Rubio, M., et al. (1994). Predominance of Gram-positive microorganisms as a cause of septicemia in patients with hematological malignancies. Infect. Control Hosp. Epidemiol. 15, 101–104.

    Article  PubMed  CAS  Google Scholar 

  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.

  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 

  9. Johansson, P.J.H., Sternby, E. and Ursing, B. (1992). Septicemia in granulocytopenic patients: a shift in bacterial etiology. Scand. J. Infect. Dis. 24, 357–360.

    PubMed  CAS  Google Scholar 

  10. Engervall, P. and Bjorkholm, M. (1995). Infections in neutropenic patients I: aetiology. Med. Oncol. 12, 251–256.

    Article  PubMed  CAS  Google Scholar 

  11. Kasthuri, A.S., et al. (1990). A clinical study of adult leukaemias. J. Assoc. Physicians India 38(6), 403–406.

    PubMed  CAS  Google Scholar 

  12. Kumar, L., Kochupillai, V. and Bhujwala, R.A. (1992). Infections in acute myeloid leukemia: study of 184 febrile episodes. J. Assoc. Physicians India 40(1), 18–20.

    PubMed  CAS  Google Scholar 

  13. Aquino, V.M., Pappo, A., Buchanan, G.R., Tkaczewski, I. and Mustafa, M.M. (1995). The changing epidemiology of bacteremia in neutropenic children with cancer. Pediatr. Infect. Dis. J. 14, 140–143.

    Article  PubMed  CAS  Google Scholar 

  14. Suppola, J.P., Kuikka, A., Vaara, M. and Valtonen, V.V. (1998). Comparison of risk factors and outcome in patients with Enterococcus faecalis vs Enterococcus faecium bacteremia. Scand. J. Infect. Dis. 30(2), 153–158.

    Article  PubMed  CAS  Google Scholar 

  15. Goldstein, E.J.C. (1996). Anaerobic bacteremia. Clin. Infect. Dis. 23(Suppl. 1), S97-S101.

    PubMed  Google Scholar 

  16. Finegold, S.M. and Wexler, H.M. (1996). Present status of therapy for anaerobic infections. Clin. Infect. Dis. 23(Suppl. 1), S9-S14.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R. Chaudhry.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mathur, P., Chaudhry, R., Kumar, L. et al. A study of bacteremia in febrile neutropenic patients at a tertiary-care hospital with special reference to anaerobes. Med Oncol 19, 267–272 (2002). https://doi.org/10.1385/MO:19:4:267

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1385/MO:19:4:267

Key Words

Navigation