This study was designed to assess types and frequency of bacteremia with a positive blood culture for Staphylococcus Spp infectious etiology of 84 enrolled patients afflicted with Acute types of leukemia, after induction phase chemotherapy .Leukemia was identified by immunophenotyping with flow cytometry. The results showed that the number and percentages of B-cell Acute Lymphoblastic Leukemia (ALL) patients were higher 38(%70.4), than T-cell ALL 16(%29.6). The highest number of the ALL patients was subtype L1 35(%64.8) .While the highest number of Acute Myeloid Leukemia (AML) subtype was M4 10(% 33,3) patients. while 31(%81.6) of B-ALL has been classified into maturational stage common-B ALL because of the positivity to CD10 and the remain 7(%18.4) were at pro-B ALL maturational stage. Also CD 34 positivity was 6 (%75.5) with mean percentage of positivity (71.70) .Isolation of bacteria by BACTEC blood culture and Identification and antibacterial susceptibility testing by VITEK2 system were done for all isolates that caused bacteremia in patients receiving induction phase chemotherapy. The results shows that after starting induction phase chemotherapy 7 isolates were observed in these patients 3(%42.9) in ALL and 4(%57.1) in AML, 5(%71.4) of these isolates were S.aureus and 1(%14.3) for each S. vitulinus and S. epidermidis . Benzylpenicillin was the most effective antibiotic against the bacterial isolates.
This study has been carried out in Erbil City -Iraq, 30 patients were diagnosis by flow cytometry as AML which they were admitted to Nanakaly Hospital for Blood Disease and submitted to chemotherapy. Number of adults/children 22 (73.3%) / 8 (26.7%), female / male 13 (43.3%) / 17(56.7%). Only 20 (66.7%) patients were smoker. The highest number was subtyping M4 10 (33.3%) patients, followed by M1 7(23.3%), M3 6(20%), M2 were 3(10%) patients. M5 and M6 were 2 (6.7%). Ten candida spp isolates before induction phase chemotherapy show 9(90%) C.albicans, 1(10%) C. lusitaniae, and from 32 isolates after induction phase chemotherapy, 17(53.1%) C.albicans, 7(21.9%) C. lusitaniae, and 8(25%) C.famata. According to the site of infection, before starting chemotherapy 8(88.9%) C. albicans isolates were in the oral cavity and 1(11.1%) on the skin, while C. lusitaniae was 1 (100%) in oral cavity only. While after chemotherapy 12(70.6%) C.albicans in the oral cavity and 5(29.4%) on the skin, C. lusitaniae was 2 (28.6%) in the oral cavity and 5(71.4%) on the skin, while all C. famata was 8 (100%) on the skin The immunophenotype shows that the number and percentage of patients which the myeloid cells expressed cyMPO was 27(90) with mean percentage of positivity 59.38, while all patients expressed CD33 and CD13 on their blast cell 30(100) with a mean percentage of positivity 59.81 and 30.83 respectively.
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