Infectious Complications of Febrile Leukopenia

Giamarellou, Helen; Antoniadou, Anastasia

doi:10.1016/s0891-5520(05)70156-2

Cited by 42 publications

(45 citation statements)

References 61 publications

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“…A changing trend from Gram-negative to Gram-positive organisms over the last two decades has been observed in some studies reported in literature especially those from the developed countries [4][5][6][7]. This change has been attributed to many factors such as widespread use of indwelling central venous access devices, use of intensive chemotherapy toxic to upper and lower gastrointestinal mucosa, use of quinolone based antibacterial chemoprophylaxis that suppresses the aerobic Gram-negative bacilli colonizing the gastrointestinal tract but fails to suppress the microaerophilic Gram-positive cocci and the use of histamine H2 receptors blockers, which reduce gastric pH and promote overgrowth of oropharyngeal Gram-positive microflora [15]. In our haematology unit, quinolones are not used for routine prophylaxis and there is restricted use of long term indwelling venous catheters.…”

Section: Discussionmentioning

confidence: 99%

Microbial Etiology of Febrile Neutropenia

Mudshingkar¹,

Gita²,

Sujata³

et al. 2010

Indian J Hematol Blood Transfus

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Bacterial and fungal infections are a major cause of morbidity and mortality among neutropenic patients. The choice of empiric antimicrobial regimen is based on susceptibility pattern of locally prevalent pathogens. From 64 febrile neutropenic patients with clinical sepsis, blood and other appropriate clinical specimens were processed to determine bacterial and fungal spectrum and their antimicrobial susceptibility pattern. Risk factors for developing sepsis were determined by case-control study. 68 organisms were recovered. Fifteen (22.05%) were Gram-positive cocci with predominance of methicillin Sensitive S. aureus (10.29%), 47 (69.11%) were Gram-negative rods with predominance of Klebsiella pneumoniae (30.88%) and four were Non albicans Candida. 81% and 60% of Klebsiella and E. coli were ESBL producers. All species of Candida were sensitive to amphoterecin B and voriconazole. Duration and extent of neutropenia, chemotherapy, immunosuppressive therapy, altered mucosal barriers and presence of central venous lines were statistically significant risk factors for developing sepsis. Gram-negative bacteria were the predominant isolates. The choice of therapy in neutropenic patients should be formulated based on local spectrum of microbes and local and regional resistance patterns.

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Section: Discussionmentioning

confidence: 99%

Microbial Etiology of Febrile Neutropenia

Mudshingkar¹,

Gita²,

Sujata³

et al. 2010

Indian J Hematol Blood Transfus

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“…The cause of this change from Gram-negative to Gram-positive organisms is not absolutely clear and is probably multifactorial. Important considerations include aggressive chemotherapeutic regimens that cause more severe mucositis, longer durations of neutropenia, increased use of central venous access device, use of H 2 antagonists, and use of prophylactic antibacterial agents with relatively weak coverage of Grampositive organisms [6,9,12].…”

Section: Discussionmentioning

confidence: 99%

Infections in a pediatric patient cohort with acute lymphoblastic leukemia during the entire course of treatment

Katsimpardi

Papadakis

Pangalis

et al. 2005

Support Care Cancer

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Most of the severe infections occurred during induction. Gram-positive bacteremia and Gram-negative bacteremia were almost equal. URIs were the commonest infections during the entire treatment and during maintenance. Specific viral infections represented a smaller percentage of the total (VZV was the commonest pathogen). Infectious complications represented a significant morbidity factor, but notably, mortality was negligible.

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“…A steady increase in gram-positive infections has occurred and now 60-70% of bacteremias with a single organism identified are caused by gram-positive cocci [4,24]. One of the important reasons is the wide use of long-term indwelling central venous catheter (CVCs) [6]. The incidence of catheter-related infections reported in the literature is around 0.2-2.9 per 1000 catheter-days, and gram-positive cocci account for 50-80% of this kind of infection [12].…”

Section: Introductionmentioning

confidence: 99%