A study of bacteremia in febrile neutropenic patients at a tertiary-care hospital with special reference to anaerobes.
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.
Mathur
P
P
Department of Microbiology, All India Institute of Medical Sciences, New Delhi-10 029, India.
Chaudhry
R
R
Kumar
L
L
Kapil
A
A
Dhawan
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology*; D001421:Bacteria, Anaerobic / Q000302:isolation & purification*; D002648:Child; D024881:Drug Resistance, Bacterial; D005334:Fever / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009503:Neutropenia / Q000382:microbiology*