Prevalence of blood stream infections and associated factors among febrile neutropenic cancer patients on chemotherapy at Ocean Road Cancer Institute, Tanzania

Abstract

Background Febrile Neutropenia (FN) caused by bacteria in cancer patients is associated with poor prognosis. The aim of this study was to determine the prevalence of FN and associated factors among cancer patients on chemotherapy at Ocean Road Cancer Institute (ORCI), Tanzania. Methods A cross-sectional study was conducted from June to September 2019. Study participants were conveniently recruited. A desk review of participants medical records was performed. Standard microbiological procedures used to culture and identify the bacterial isolates from the positive blood cultures of participants that presented with FN. Kirby-Bauer disc diffusion was used to perform the antibiotics susceptibility testing. SPSS version 20.0 and MS Excel were used in data entry and analysis. Chi-Square was used as a measure of association between various factors and neutropenia. P-value less than 0.05 was considered statistically significant. Results A total 213 participants were enrolled. Of these 76.1% were female. Most of the participants came from the Coast region. Majority of participants presented with breast Cancer (36.2%) and GIT (20.2%). The prevalence of FN and bacteremia was 5.6% and 35.3% respectively. Staphylococcus Aureus (60%) and Coagulase-Negative Staphylococci (40%) were the main isolates. Of the 6 isolates tested most were resistant to Co-Trimoxazole 4/6 (66.7%) and Doxycycline 3/6 (50%). FN was positively associated with chemotherapy regimen (P = 0.0001), platelets count (P = 0.0001) and use of G-CSF (P = 0.0001). Conclusion The prevalence of FN among the cancer patients on chemotherapy in Tanzania is low but associated with drug-resistant bacteria.

Survivorship Struggles: Navigating Etiologies and Clinical Parameters of Febrile Neutropenia During Induction Chemotherapy in Acute Leukemia Patients

“…A developing nation such as Pakistan grapples with the complexities of the management of febrile neutropenia, where limited resources and access to advanced medical care add a layer of adversity [ 9 ]. Statistics from different developing countries report high mortality in acute leukemia, ranging between 25% to 35%, which is consistent with the results of our study [ 9 - 11 ]. However, studies from developed countries in Europe, China, and North America report a lower mortality rate of 5% to 10% [ 3 , 6 , 12 ].…”

“…This pattern is consistent with findings from other studies, which report nearly 70% of the infections in complicated febrile neutropenia are hospital-acquired [ 9 , 17 ]. The widespread challenge posed by these multidrug-resistant gram-negative organisms in causing severe infections jeopardizes patient outcomes and increases the risk for mortality [ 2 , 11 ]. Similarly, the heightened prevalence of multidrug-resistant gram-positive strains also advocates this finding.…”