title: Micro-organisms Associated with Febrile Neutropenia in Patients with Haematological Malignancies in a Tertiary Care Hospital in Eastern India.
abstract: There is paucity of information from eastern India with regard to observed dominant micro-organisms causing febrile neutropenia (FN) in patients with haematological malignancies. To identify the prevalence of pathogenic microorganisms associated with FN. A total number of 268 episodes of FN were analysed from September'2010 to October'2013. The blood samples were inoculated into brain heart infusion broth, glucose broth, Hicombi dual performance media (Himedia, LQ-12) at 37° C for 168 h and Bactec method was also performed for these samples. Blood agar, chocolate agar, MacConkey's agar and cystine lactose electrolyte deficient agar were used for isolation of the microorganisms. A total number of 78 (29.10 %) episodes revealed positive growths. Gram negative bacilli and Gram positive cocci were isolated in 61.53 and 34.61 % cases respectively. The eight commonest isolates were Pseudomonas aeruginosa (14.10 %), methicillin resistant Staphylococcus aureus (MRSA-12.82 %), Acinetobacter sps (11.53 %), coagulase negative Staphylococcus (10.25 %), Klebsiella pneumoniae (8.97 %), Escherichia coli (8.97 %), ESBL E. coli (6.41 %), methicillin sensitive S. aureus (MSSA-6.41 %). Amongst other less common isolates were Citrobacter kosseri (3.84 %), Citrobacter freundii (2.56 %), Ralstonia paucula (2.56 %), Cedecia neteri (1.28 %), methicillin resistant coagulase negative Staphylococcus (2.56 %). Candida spp. including two cases of Candida non-albicans was isolated in 3.84 % of cases. P. aeruginosa was the commonest pathogenic isolates in FN patients associated with haematological malignancies in this study. Gram negative bacteria were the commonest isolates in FN including significant numbers of rare opportunistic micro-organisms.
authors.affiliation: Department of Hematology, NRS Medical College, 138, AJC Bose Road, Kolkata, 700014 India.
authors.forename: Prakas Kumar
authors.initials: PK
authors.lastname: Mandal
authors.affiliation: Department of Microbiology, Vidyasagar University, Midnapore, 721101 West Bengal India.
authors.forename: Suman Kumar
authors.initials: SK
authors.lastname: Maji
authors.affiliation: Department of Hematology, NRS Medical College, 138, AJC Bose Road, Kolkata, 700014 India.
authors.forename: Tuphan Kanti
authors.initials: TK
authors.lastname: Dolai
authors.affiliation: Department of Hematology, NRS Medical College, 138, AJC Bose Road, Kolkata, 700014 India.
authors.forename: Rajib
authors.initials: R
authors.lastname: De
authors.affiliation: Department of Hematology, NRS Medical College, 138, AJC Bose Road, Kolkata, 700014 India.
authors.forename: Shyamali
authors.initials: S
authors.lastname: Dutta
authors.affiliation: Department of Hematology, NRS Medical College, 138, AJC Bose Road, Kolkata, 700014 India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Saha
authors.affiliation: Department of Hematology, NRS Medical College, 138, AJC Bose Road, Kolkata, 700014 India.
authors.forename: Maitreyee
authors.initials: M
authors.lastname: Bhattacharyya
keywords: Blood stream infection; Febrile neutropenia; Gram negative organisms