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

Med Oncol. 2002;19(4):267-72. doi: 10.1385/MO:19:4:267.

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bacteremia / drug therapy
  • Bacteremia / microbiology*
  • Bacteria, Anaerobic / isolation & purification*
  • Child
  • Drug Resistance, Bacterial
  • Fever / microbiology*
  • Humans
  • Microbial Sensitivity Tests
  • Middle Aged
  • Neutropenia / microbiology*