title: Frequency of bacterial isolates and pattern of antimicrobial resistance in patients with hematological malignancies: A snapshot from tertiary cancer center.
abstract: BACKGROUND
  Infections are the most important cause of mortality in patients with high-risk febrile neutropenia. Emergence of multi-drug resistant organisms (MDROs) has become a major challenge for hemato-oncologists. Knowledge of the prevalent organisms and their antimicrobial sensitivity can help deciding the empirical therapy at individual centers and allows timely measures to reduce the risk of antimicrobial resistance.
  
  
  OBJECTIVE
  To evaluate the frequency of bacterial isolates from all the samples and the pattern of bacterial bloodstream infections and incidence of MDROs.
  
  
  METHODS
  This is a retrospective analysis from a tertiary care cancer center.
  
  
  METHODS
  From January to June 2014 information on all the samples received in Department of Microbiology was collected retrospectively. The data from samples collected from patients with hematological cancers were analyzed for types of bacterial isolates and antimicrobial sensitivity.
  
  
  RESULTS
  A total of 739 isolates were identified with 67.9% of isolates being Gram-negative. The predominant Gram-negative organisms were Escherichia coli, Psuedomonas spp. and Klebsiella spp. Among the bacterial bloodstream infections, 66% were Gram-negative isolates. MDROs constituted 22% of all isolates in blood cultures. Incidence of resistant Gram-positive organisms was low in the present dataset (methicillin resistant Staphylococcus aureus and vancomycin-resistant enterococci-1.3%).
  
  
  CONCLUSIONS
  The analysis reconfirms the Gram-negative organisms as the predominant pathogens in bacteremia seen in patients with hematological cancers. The high frequency of multi-drug resistance in the dataset calls for the need of emergency measures to curtail further development and propagation of resistant organisms.
authors: Department of Medical Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India.
authors: M
authors: M
authors: Sengar
authors: R
authors: R
authors: Kelkar
authors: H
authors: H
authors: Jain
authors: S
authors: S
authors: Biswas
authors: P
authors: P
authors: Pawaskar
authors: A
authors: A
authors: Karpe
mesh_terms: D000150:Acinetobacter / Q000187:drug effects / Q000302:isolation & purification; D016470:Bacteremia / Q000382:microbiology*; D002173:Cancer Care Facilities; D024901:Drug Resistance, Multiple, Bacterial; D016983:Enterococcus / Q000187:drug effects / Q000302:isolation & purification; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification; D064147:Febrile Neutropenia / Q000150:complications*; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D007709:Klebsiella / Q000187:drug effects / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D011549:Pseudomonas / Q000187:drug effects / Q000302:isolation & purification; D013183:Sputum / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013291:Streptococcus / Q000187:drug effects / Q000302:isolation & purification; D062606:Tertiary Care Centers; D014556:Urine / Q000382:microbiology