Vol - 28, Issue - 07
About the Journal
[This article belongs to Volume - 28, Issue - 07]
International Medical Journal
Journal ID : IMJ-08-08-2021-865
Total View : 465

Abstract : Febrile neutropenia (FN) is one of the most important clinical challenge faced in the course of treatment of patients with hematological malignancies. Infection is an important complication of neutropenia and is associated with a high morbidity and mortality. We attempted to revisit the common organisms implicated in this group of patients in addition to find their sensitivity patterns. A prospective cross sectional study was carried out at IMS and SUM Hospital over a period of 6 months in patients with hematological malignancies (n=72) presenting with fever and neutropenia. Blood samples were collected from all patients; urine, sputum, mucosal ulcer swabs were collected when symptoms and signs suggestive of specific etiology was suspected and processed for aerobic bacterial as well as fungal culture and sensitivity. The most common underlying hematological disorder in FN was acute myeloid leukemia (AML, 45.8%) followed by acute lymphoid leukemia (ALL, 16.7%) and aplastic anemia (13.9%). Bacteremic episodes were present in 20.8% (15/72) of blood samples. Of 20 sputum samples, 30% (6/20) had a significant bacterial growth. Similarly, bacterial growth was seen in 25% (3/12) of urine culture samples and 14.3% (1/7) mucosal samples. Of all samples from blood, urine, sputum and mucosa with bacterial growth (n=25), Klebsiella pneumoniae (52%; 13/25) followed by isolates of E. coli (24%; 6/25) were the most predominant organisms isolated. All the isolated enterobacterales were highly resistant to piperacillin tazobactam (71.4%), meropenem (71.4%), netilmycin (64.3%) and tigecycline (57.2%). Colistin was sensitive in all the cases. This study reiterates the fact that unlike Western countries, gram negative pathogens are the flag bearers of infection in FN cases in our country. Multi drug resistant Klebsiella spp. was the predominant organism causing bacteremia in these cases.

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