Bacterial Isolates and Characteristics of Children With Febrile Neutropenia on Treatment for Cancer at Moi Teaching and Referral Hospital, Kenya.

Abstract

Purpose This study aimed at identifying the patient characteristics of children with febrile neutropenia, the associated bacterial organisms, and their sensitivity patterns. Methods A descriptive cross-sectional study was carried out at the MTRH, paediatric oncology ward, from June 2021 to April 2022. A total of 110 children who developed fever and neutropenia while on chemotherapy were enrolled. Blood samples for culture were drawn aseptically. Patient characteristics were presented in frequency tables. Antimicrobial sensitivity patterns were plotted in tables against the bacterial isolates cultured. Chi-square/Fischer’s exact test were used to determine any association between patient characteristics, bacterial growth and antimicrobial sensitivity. Results Majority 66 (60%) were males. The median age was 6.3 (SD 3.7) years. Majority of the patients 71 (64.5%) had haematological malignancies, the most common being Acute Myeloid Leukaemia (AML). There was a significant association between severity of neutropenia and haematological malignancies p = 0.028. In total, 31/110 (28.2%) blood cultures were positive for bacterial growth. Gram-positive bacteria were more frequent at 20 (58.1%). The most common organism was Escherichia coli 6 (18.2%), followed by Staphylococcus aureus at 5 (15.2%.) All the isolates were sensitive to linezolid and vancomycin and also showed good sensitivity towards meropenem at 10/11 (90.9%). High resistance to cephalosporins was noted with ceftriaxone at 5/6 (83.3%), cefepime at 4/7 (57.1%) and ceftazidime at 3/4 (75%). Conclusion The most common malignancy associated with febrile neutropenia was AML. Gram-positive bacteria were the most common isolates. There was high resistance towards cephalosporins but all were sensitive to linezolid and vancomycin.