Infection Analysis in Acute Lymphoblastic Leukemia: A Report of 499 Consecutive Episodes in India

Raje, Nikita; Rao, Suresh Ranga; Iyer, R. S.; Kelkar, Rohini; Pai, Swati; Nair, C. N.; Pa, Kurkure; Magrath, I. T.; Advani, Suresh H.

doi:10.3109/08880019409141670

Cited by 22 publications

(10 citation statements)

References 16 publications

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“…Similar to our study the presence of P. aeruginosa as an infectious pathogen was also observed by Raje et al, [50]. They reported P. aeruginosa (28%) as a major pathogen in febrile neutropenic patients of acute lymphobalastic leukemia cases.…”

Section: Discussionsupporting

confidence: 92%

Incidence and risk factors for infection in oral cancer patients undergoing different treatments protocols

et al. 2012

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BackgroundOver the past decade, advances in cancer treatments have been counterbalanced by a rising number of immunosuppressed patients with a multitude of new risk factors for infection. Hence, the aim of this study was to determine risk factors, infectious pathogens in blood and oral cavity of oral cancer patients undergoing different treatment procedures.MethodsThe present prospective cohort analysis was conducted on the patients undergoing treatment in the radiotherapy unit of Regional Cancer Institute, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, during the period of January 2007 to October 2009. Total 186 patients with squamous cell carcinoma of oral cavity were analyzed in the study. Based on treatment procedures patients were divided into three groups, group I were under radiotherapy, group II under chemotherapy and group III were of radio chemotherapy together. Clinical isolates from blood and oral cavity were identified by following general microbiological, staining and biochemical methods. The absolute neutrophile counts were done by following the standard methods.ResultsPrevalent bacterial pathogens isolated were Staphylococcus aureus, Escherichia coli, Staphylococcus epidermidis, Pseudomonas aeruginosa, Klebsiella pneumonia, Proteus mirabilis, Proteus vulgaris and the fungal pathogens were Candida albicans, Aspergillus fumigatus. The predominant gram negative bacteria, Pseudomonas aeruginosa and Klebsiella pneumonia were isolated from blood of radiotherapy and oral cavity of chemotherapy treated cases respectively. The predominance of gram positive bacteria (Staphylococcus aureus and Staphylococcus epidermidis) were observed in blood of chemotherapy, radio chemotherapy cases and oral cavity of radiotherapy, radio chemotherapy treated cases. Our study also revealed the presence of C. albicans fungi as most significant oral cavity pathogens in radiotherapy and radio chemotherapy cases.ConclusionGram positive bacteria and Gram negative were reported from the blood of all the three groups of patients. Oral mucositis played a significant role in oral cavity infection and make patients more prone to C. albicans infection.

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Section: Discussionsupporting

confidence: 92%

Incidence and risk factors for infection in oral cancer patients undergoing different treatments protocols

et al. 2012

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“…For example, P. aeruginosa infection appears to be more prevalent in warmer climates. It accounted for as many as 27% of pathogens isolated from febrile neutropenic patients an Indian hospital [9]. Therefore, data that are reported from the United States and Europe may not be fully representative of what is seen as the bacterial etiology of febrile neutropenia in developing nations, and specific institutions may not show the general pattern if they eschew antibiotic prophylaxis.…”

Section: General Factors Affecting the Etiology Of Bacteremiamentioning

confidence: 83%

Changes in the Etiology of Bacteremia in Febrile Neutropenic Patients and the Susceptibilities of the Currently Isolated Pathogens

2004

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The etiology of bacteremia in febrile neutropenic patients in the past few decades has shifted from gram-negative to gram-positive organisms. Potential reasons include the use of indwelling catheters, local environmental conditions, and the administration of specific antibiotic agents, especially as prophylaxis. Other factors may emerge from new studies, such as the categorization of febrile neutropenic patients into groups at low risk and at high risk of developing serious complications, continuing changes in resistance in the community, the use of antibiotic-coated catheters, and future changes in cytotoxic chemotherapy or antineoplastic therapy. In addition, there has been a drift in susceptibility patterns, with resistance issues seen in the general population of hospitalized patients now emerging in febrile neutropenic patients, as well as some issues specific to these patients. These changes affect empirical therapy as it was practiced a decade ago. Among the most commonly used agents, cefepime and carbapenems continue to show the highest rates of in vitro susceptibility, providing coverage against most gram-positive and gram-negative organisms and reducing the need for glycopeptides. Older agents continue to show degradation of their effectiveness. Among Pseudomonas aeruginosa strains, susceptibility to all agents continues to decline.

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“…Enterobucter spp., Pseudomonus spp., and viridans streptococci have recently become troublesome causes of septicemia [8,9]. In the developing countries where pediatric oncology is currently an emerging service, the profile of infections is similar to earlier periods in the industrialized countries [2]. Intensive chemotherapy protocols introduced at Tawam Hospital in the late 1980s brought a significantly higher rate of cure in children with cancer but also an increased risk of serious infections.…”

Section: Phase Of Treatment and Outcome Of The Infectionmentioning

confidence: 99%

Febrile Episodes in Children with Cancer in the United Arab Emirates

Mahmood

Revesz

Mpofu

1996

Pediatric Hematology and Oncology

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The febrile episodes encountered in our pediatric oncology unit over a 2-year period were reviewed. A total of 138 febrile episodes were recorded in 59 patients (29 with leukemia and 30 with a solid tumor). There was no difference in the number of episodes between leukemia and solid tumor patients, nor between neutropenic and non-neutropenic patients. The degree of neutropenia was more severe in leukemia patients. A total of 18.8% of the episodes were accompanied by positive blood cultures. Gram-positive bacteria were more frequent than gram-negative bacteria, and there were four anaerobic isolates. Seventeen episodes were accompanied by clinical signs of central venous line (CVL) infection. A total of 70.2% of the episodes resolved with a first-line antibiotic combination of flucloxacillin, piperacillin, and netilmicin, 27.5% required modification of the antibiotic combination, and three patients (5%) died due to gram-negative septicemia. These findings indicate that the pattern of infectious complications in the United Arab Emirates is now similar to that observed in Europe and the United States.

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Infection Analysis in Acute Lymphoblastic Leukemia: A Report of 499 Consecutive Episodes in India

Cited by 22 publications

References 16 publications

Incidence and risk factors for infection in oral cancer patients undergoing different treatments protocols

Incidence and risk factors for infection in oral cancer patients undergoing different treatments protocols

Changes in the Etiology of Bacteremia in Febrile Neutropenic Patients and the Susceptibilities of the Currently Isolated Pathogens

Febrile Episodes in Children with Cancer in the United Arab Emirates

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