Clinical and microbiological profile of febrile neutropenia in solid tumors and hematological malignancies at a tertiary cancer care center in South India

Jacob, LA; Lakshmaiah, K C; Govindbabu, K.; Suresh, T. M.; Dasappa, Lokanatha; Sinha, Mahua; Vijaykumar, BR; Sumathi, B; Jayashree, R.

doi:10.4103/0019-509x.175330

Cited by 22 publications

(33 citation statements)

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“…In a study of Jacob et al the most common hematological malignancy was AML in febrile neutropenic patients [7]. Also, the most common hematologic malignancy was AML (46,5%) in this study.…”

Section: Discussionsupporting

confidence: 62%

Epidemiology and mortality in bacterial bloodstream infections in patients with hematologic malignancies

Mert

Çeken

İskender

et al. 2019

J Infect Dev Ctries

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Introduction: Patients with hematological malignancies, who are in the high risk group for infectious complications and bacterial bloodstream infections. The aim of the study evaluated epidemiology and mortality in bacterial bloodstream infections in patients with hematologic malignancies. In addition to determine the risk factors, changes in the distribution and frequency of isolated bacterias. Methodology: In this retrospective study. There were investigated data from 266 patients with hematological malignancies and bacterial bloodstream infections who were hospitalized between the dates 01/01/2012 and 12/31/2017. Results: There were 305 blood and catheter cultures in febrile neutropenia attacks in total. In these total attacks, primary bloodstream infections were 166 and catheter-related bloodstream infections were 139. In blood cultures; Escherichia coli and Klebsiella pneumoniae bacteria were detected in 58,0% and 22,9% of the samples, respectively. 52,4% of the cultured Gram-negative bacterias were extended spectrum beta-lactamase (ESBL). Carbapenemase positive culture rate was 17,2% in Gram-negative bacteria cultures. Staphylococcus epidermidis was found in 38,4% of the Gram-positive bacteria cultures. In Gram-positive bacteria; methicillin resistance were detected in 82,2% of the samples. There was a statistically significant relationship between bloodstream infection and disease status. 60 patients with primary bloodstream infections were newly diagnosed. Conclusions: In patients with hematological malignancies, certain factors in the bloodstream infections increase the mortality rate. With the correction of these factors, the mortality rate in these patients can be reduced. The classification of such risk factors may be an important strategy to improve clinical decision making in high-risk patients, such as patients with hematological malignancies.

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“…In a study of Jacob et al the most common hematological malignancy was AML in febrile neutropenic patients [7]. Also, the most common hematologic malignancy was AML (46,5%) in this study.…”

Section: Discussionsupporting

confidence: 62%

Epidemiology and mortality in bacterial bloodstream infections in patients with hematologic malignancies

Mert

Çeken

İskender

et al. 2019

J Infect Dev Ctries

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“…Febrile neutropenia (FN) is a medical emergency, leads to a large number of hospital admissions and contributes to morbidity and mortality in the hematology patient population [3–5]. Fever may represent the only hallmark of blood stream infection (BSI) in the neutropenic patient, with the usual focal symptoms and signs typically attenuated by the absence of functional innate immunity [6, 7].…”

Section: Introductionmentioning

confidence: 99%

“…Progression to septic shock and multi-organ failure carries a mortality of up to 40% when gram-negative organisms are implicated. FN also has a significant impact on morbidity and an indirect effect on mortality due to delays in chemotherapy administration and alterations in dosing [3, 8]. …”

Section: Introductionmentioning

confidence: 99%

“…Despite a diagnostic focus on bacteremia and concern about resulting clinical sepsis, microbiological confirmation of BSI only occurs in 15% to 35% of cases of FN, and reported in-hospital mortality ranges from 3 to 39% [3, 4, 9]. This wide range is attributable, in part, to the emerging challenge of multi drug-resistant organisms in some populations, particularly the gram-negative bacteria [10].…”

Section: Introductionmentioning

confidence: 99%

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Low rates of antibiotic resistance and infectious mortality in a cohort of high-risk hematology patients: A single center, retrospective analysis of blood stream infection

et al. 2017

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Febrile neutropenia (FN) is a medical emergency and can represent a life-threatening complication for hematology patients treated with intensive chemotherapy regimens. In clinical practice, the diagnostic yield of blood cultures and other investigations which aim to identify a causative organism or site of infection is low. We have retrospectively examined all blood cultures collected in a “real world” cohort of patients receiving chemotherapy for acute leukemia and patients with aggressive lymphoma treated with Hyper-CVAD/MTX-cytarabine, at a single tertiary center over a five-year period. In this cohort, the 30-day mortality following confirmed blood stream infection (BSI) was 5.9%, which is lower than most reports in the recent literature. We compared the blood culture results of inpatients undergoing induction chemotherapy and outpatients presenting with fevers and found a significantly higher rate of proven BSI in the outpatient group. In all settings, gram-negative organisms were most common. The rate of resistance to first-line empiric antibiotics among pathogenic isolates was 11.6% in the whole cohort, independent of blood culture circumstances. There was a trend to higher resistance rates among inpatients undergoing induction chemotherapy compared to patients presenting to the emergency department (17.4% vs 7.5%) but this did not reach statistical significance. We also report low rates of ciprofloxacin resistance (5% of isolates), in a center where universal fluoroquinolone prophylaxis is not employed. Our low resistance and mortality rates support our current therapeutic strategies, however presence of resistant organisms across the spectrum of indications for BC collection highlights the importance of surveilling local patterns, escalating antimicrobial therapy in the deteriorating patient, and considering advanced techniques for the rapid identification of resistance in this patient population.

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“…This single center hospital based study was planned to evaluate the microbiological flora, MASCC score correlation and other clinical variables among febrile neutropenic patients in solid and hematological malignancies [5,6].…”

Section: In 2000mentioning

confidence: 99%

Clinical Profile, Outcome and Application of MASCC Scoring in Febrile Neutropenic Patients

Kumar¹,

Suhail²,

Maka³

et al. 2017

Arch Can Res

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Clinical and microbiological profile of febrile neutropenia in solid tumors and hematological malignancies at a tertiary cancer care center in South India

Abstract: Empiric antibiotic treatment for FN should be tailored to the locally prevalent pathogens and their susceptibility patterns.

Cited by 22 publications

References 0 publications

Epidemiology and mortality in bacterial bloodstream infections in patients with hematologic malignancies

Epidemiology and mortality in bacterial bloodstream infections in patients with hematologic malignancies

Low rates of antibiotic resistance and infectious mortality in a cohort of high-risk hematology patients: A single center, retrospective analysis of blood stream infection

Clinical Profile, Outcome and Application of MASCC Scoring in Febrile Neutropenic Patients

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