Frequency of bloodstream infection in febrile neutropenic patients, experience from a developing country

Siddiqui, Basit; Azmat, Rabeea; Tikmani, Shiyam Sunder; Rafi, Shumaila; Syed, Beenish; Khan, Muhammad Tahir; Rehman, Hareem; Paracha, Saleemullah

doi:10.1016/j.amsu.2018.09.004

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…In this study, we evaluated the sites of infection in patients with febrile neutropenia, the causative microorganisms in the culture-positive cases and their antibiotics sensitivity, the mortality rate and outcome of patients and the association between the development of neutropenic fever and the duration of neutropenia. In this study, there was slight predominance of male (56%) over female (44%) with male: female ratio 1.3:1 similar result was found in a study by Siddiqui et al in which 60% were male with male to female ratio of 1.5:1 [37].…”

Section: Discussionsupporting

confidence: 90%

Current Sites of Infections and Types of Microorganisms in Patient with Febrile Neutropenia in Hematological Wards – Single Center Study

Naji¹,

SarKo

Atta

2022

Open Access Maced J Med Sci

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BACKGROUND: Febrile neutropenia occurs in more than 80% of patients with hematological malignances specially after chemotherapy cycles and an infectious source is identified in approximately 20–30%. Various bacterial, viral, and fungal pathogen contribute to the development of neutropenic fever and without prompt antibiotic therapy mortality rate can be as high as 70%. AIM: The objective of the study was to document the current sites of infection in patients with febrile neutropenia in hematological ward in Baghdad Teaching Hospital, the microorganisms and antibiotic susceptibly in culture positive cases and mortality rate in 1 week and 4 weeks after episode of fever. PATIENTS AND METHODS: One hundred cases of febrile neutropenia were evaluated in Hematological Ward of Baghdad Teaching Hospital from January 2019 to January 2020. Detailed history, physical examination, and laboratory investigations were conducted and statistical analysis of the results was done. RESULTS: One hundred cases of febrile neutropenia, mean age of presentation was 41.56 ± 10.5 years. Acute myeloid leukemia (36%) and acute lymphocytic leukemia (26%) were the most common underlying hematological disorder, followed by Aplastic Anemia, Non-Hodgkin Lymphoma, and Hodgkin Lymphoma. Temperature ranged from 38°C to 39°C with mean temperature of 38.4°C and most of the patient presented with short duration of fever, 57% had absolute neutrophil count below 150 cells/μL with mean duration of neutropenia was 14.01 days. Respiratory tract was the most common site of infection (52%) followed by urinary tract (18%) and in 16% had no obvious focus of infection. Thirty percent of cases were culture Gram-positive and Gram-negative microorganism which were more common 62.9% which were generally sensitive to Aminoglycosides while Gram-positive microorganism constituted 29.6% of isolated bacteria and were generally sensitive to vancomycin. No mortality documented 1 and 4 weeks after fever. CONCLUSION: We concluded that the most frequent sites of infection in patient with febrile neutropenia were respiratory tract followed by urinary tract infection, while 16% had undetermined source of infection. Thirty percent of patients had a positive blood culture with Escherichia coli being the most common infecting microorganism, Gram-negative microorganisms were more common than Gram-positive microorganism and fungal infection constituted about 6% of growth. Significant association was found between the fever and longer duration of neutropenia and the greater severity of neutropenia was observed. No mortality related to febrile neutropenia was documented.

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Section: Discussionsupporting

confidence: 90%

Current Sites of Infections and Types of Microorganisms in Patient with Febrile Neutropenia in Hematological Wards – Single Center Study

Naji¹,

SarKo

Atta

2022

Open Access Maced J Med Sci

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“…In Spain, Royo-Cebrecos and colleagues [ 28 ] found that the most common etiological agents in polymicrobial BSIs were GNB, and E. coli strains were particularly common. Siddiqui et al [ 29 ] identified S. aureus, E. coli, Pseudomonas spp., and Klebsiella spp. as the most common BSI agents in febrile neutropenic patients in Pakistan.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Blood Culture Results in Patients with Malignancy in Erzurum Province, Turkey

Aktas,

Akbaba,

Uyanik

et al. 2024

AML

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Background: Bloodstream infections are a serious public health problem that requires follow-up with blood culture; this negatively affects the course of the disease and patient healthcare costs in patients with malignancy. This study aimed to determine the growth frequency of pathogens and their antibiotic resistance profiles in the blood cultures of patients with hematological and oncogenic malignancies.Materials and methods: The results of 7451 blood cultures, obtained from 2926 patients between January 2017 and January 2022, were evaluated retrospectively. Of these cultures, 3969 were obtained from patients with malignancy (diagnostic codes C00-D48 in ICD-10) and 3482 from patients without malignancy. The hospital information management system modules were used to acquire patient data and blood culture results.Results: Various microorganisms grew in 10.1% of blood cultures. Of these organisms, 64.1% were isolated from cases of malignancy. Of the pathogens, 49.2% were gram-negative bacteria, 47.7% were gram-positive bacteria, and 3.1% were fungi. The most frequently isolated bacteria were methicillin-resistant coagulase-negative staphylococci (3.2%), Escherichia coli (2.3%), Klebsiella pneumoniae (1.0%), methicillin-sensitive coagulase-negative staphylococci (0.7%), and Staphylococcus aureus (0.6%). Pathogen positivity was highest in the patient cultures with urinary system cancer (23.9%), thyroid and other endocrine gland cancers (20.6%), female and male genital organ cancers (18.2%/16.9%), and digestive organ cancer (14.2%). Gram-negative bacteria to ampicillin, piperacillin, and sulfamethoxazole-trimethoprim and Gram-positive bacteria to penicillin, erythromycin, and sulfamethoxazole-trimethoprim were highly resistant. Combined resistance to imipenem and meropenem was observed in 25 Gram-negative bacteria. Twelve (48%) of the carbapenem-resistant bacteria were isolated from patients with lymphoid, hematopoietic, and related tissue malignant neoplasia.Conclusion: This study reported microorganisms and their antimicrobial resistance in the blood cultures of malignant patients, a special patient group. It pointed out that the antibiotic resistance of Staphylococcus, Klebsiella pneumoniae, and E. coli is high enough to cause problems in the treatment of patients with malignancy.

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“…6 A study done in Karachi, Pakistan to determine frequency of BSI in adult population with febrile neutropenia showed that frequency of Staphylococcus aureus was 16%, E. coli 14.5%, Pseudomonas 8.5% and Klebsiella 15.5 %. 7 Another study done at Agha Khan University Hospital, Karachi from 2013 to 2017 concluded that most common pathogen of BSI is staphylococcus non-aureus species (33.3%). 8 It has been observed that frequency and types of nosocomial infections and pathogens causing BSI show demographical variation.…”

Section: Introductionmentioning

confidence: 99%

Nosocomial Blood Stream Infections in Pediatric Intensive Care Unit of Fauji Foundation Hospital, Rawalpindi Pakistan

Ayaz

Hameed

Amber

et al. 2020

J Islamabad Med Dental Coll

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OBJECTIVE: To determine the frequency of most common bacterial organisms in nosocomial blood stream infections STUDY DESIGN: A Cross-sectional descriptive study PLACE AND DURATION: In Department of Paediatric Medicine, Fauji Foundation Hospital, Rawalpindi, Tertiary care hospital over a period of 06 months from 6th July 2017 to 6th Jan 2018 METHODOLOGY: Total 385 patients admitted in PICU were included in the study according to the inclusion criteria. Patients were monitored from the time of admission to their final outcome for development of hospital acquired infections, based on standard definitions. Blood sample for culture were collected aseptically according to the protocol of the microbiology laboratory. The bottles were incubated for 7 days. Patients were monitored from time of the blood culture yielding growth until culture report becomes available. Data was calculated through a structured Performa confidentiality of patient was maintained. RESULTS: Pseduomonas Aeruginosa and Salmonellia Tpyhi were the most common bacterial organism 83 (21.6) in nosocomial blood stream infection whereas E.Coli and Klebsiella found in 77 (20.0) and 67 (17.4) patients respectively. CONCLUSION: The study concluded that the frequency of most common bacterial organisms in nosocomial blood stream infections is substantial. Thus, early initiation of appropriate antibiotic therapy help in contributing significantly towards decrease in mortality rates due to blood stream infections. KEYWORDS: Nosocomial, Bloodstream infection, Intensive care unit

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Frequency of bloodstream infection in febrile neutropenic patients, experience from a developing country

Cited by 4 publications

References 17 publications

Current Sites of Infections and Types of Microorganisms in Patient with Febrile Neutropenia in Hematological Wards – Single Center Study

Current Sites of Infections and Types of Microorganisms in Patient with Febrile Neutropenia in Hematological Wards – Single Center Study

Evaluation of Blood Culture Results in Patients with Malignancy in Erzurum Province, Turkey

Nosocomial Blood Stream Infections in Pediatric Intensive Care Unit of Fauji Foundation Hospital, Rawalpindi Pakistan

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