Infection Pattern of Neutropenic Patients in Post-Chemotherapy Phase of Acute Leukemia Treatment

Abstract

Neutropenia following chemotherapy regimens in leukemia patients is of major concern since it makes these patients vulnerable to infections. If we can identify which germs are causing these infections, they can be annihilated or, at least, the most appropriate antibiotic therapy can be started immediately, even before we have the results of the culture. This retrospective multi-center study took place in 2012 and included patients with acute leukemia who had already undergone chemotherapy and who had been febrile for at least 16 hours. In order to assess the type of infection, different environments were chosen and the results were compared by t-test and χ2 tests. This study took place in four hospitals in Tehran and Ahwaz, Iran. The study population was made up of 89 patients: 37 with acute lymphoblastic leukemia and 52 with acute myeloid leukemia. The results revealed that blood was the most common site of infection. From all our positive cultures, it was seen that 85.4% of them had gram-negative bacteria with a dominance of E. coli of 25.8% over the other colonies. Also, antibiograms revealed the sensitivity of almost all the gram-negatives to amino glycosides. In contrast with most of the literature, in our patients, gram-negatives are the most common cause of infection and, therefore, administering amino glycosides would be the safest antibiotic therapy to prescribe before culture results are available.

Outcome of Febrile Neutropenia in Children with Cancer: Experience from a Tertiary Health Care Center

“…Bloodstream infection was the most common site of infection in febrile neutropenic patients mentioned by several studies. 11 In this current study, majority (11.7%) organisms were isolated from blood. Time to antibiotics is also considered as an important predictor of outcome in FN; in different studies.…”

Management of febrile neutropenia: A description of clinical and microbiological findings by focusing on risk factors and pitfalls

“…In another retrospective multicenter study took place in four hospitals in Tehran and Ahwaz, Iran, 89 patients suffering from leukemia were assessed microbiologically and it was noted that 85.4% of total culture had Gram-negative bacteria with a dominance of Escherichia coli colonies. [ 19 ]…”

Molecular Detection of Cytomegalovirus in a Sample of Iraqi Patients With Acute Leukemia and Stem Cell Transplantation

“…Statistically significant difference according to hematological parameters between the HCMV positive and HCMV negative patients (group I and group II) was found as shown in table (4). *Leukopenia (WBC count < 4.0×103/μl) (22) .…”

“…These methods cause an increased Iraqi JMS 2018; Vol. 16(3) risk of infections (4) . Patients undergone SCT are more susceptible because their immune system is depressed by immunosuppressive therapy and the immune reconstitution is not fully developed.…”