1096. Microbiological Trends and Antimicrobial Sensitivity Profile of Febrile Neutropenic Episodes in Hematological Malignancy Patients -- A Report From a Tertiary Center of a Developing Country
Session: Poster Abstract Session: Infections in Hematopoietic Stem Cell Transplant and Cancer Chemotherapy Recipients
Saturday, October 22, 2011
Room: Poster Hall B1
Background:

Neutropenia, resulting from cytotoxic chemotherapy is the most common risk factor for severe infections in hematological malignancies. Febrile neutropenia during chemotherapy is a medical emergency and early administration of antimicrobial agents is recommended. The pattern of infection in febrile neutropenia is changing – showing a trend towards Gm +ve organisms as well as emergence of resistance to antimicrobial agents

Methods:

We studied 25 patients of hematological malignancies with 78 episodes of febrile neutropenia. The patients were treated according to IDSA 2010 guideline for management of febrile neutropenia .Blood culture was sent at the onset of fever before starting empiric therapy.

Results: 

In 31 episodes (39.74% of total), a definite organism could be isolated.  Amongst the culture positive episodes, Gram negative organisms were isolated in 18 (58.06%)  .  E. coli and  Klebsiella species, each of which were isolated in  5 ( 16.13% ) episodes  , while  Pseudomonas aeruginosa and Acinetobactor species in 3  (9.68%) episodes each. In 2 episodes  Citrobacter koseri and Citrobacter freundii were isolated.  Gram positive coagulase negative Staphylococcus Aureus was detected in 10  (32.26%). Incidence of Methicillin Resistant Staphylococcus Aureus infections were more  (8 episodes, 25.81%)  than Methicillin Sensitive Staphylococcus Aureus   (2 episodes,6.45%) . Most Gram negative organisms were sensitive to Pipracillin-tazobactum except Acinetobactor & Citrobacter . Two episodes (6.44%)-- one each of Candida albicans and Candida Krusei   was also isolated and both were sensitive to Amphotericin B .

Conclusion: 

Incidence of gram positive bacterial infections are increasing. Infection with opportunistic gram negative organisms are also becoming important in febrile neutropenia patients.


Subject Category: J. Clinical practice issues

Prakash Mandal, Post Doctoral Trainee1, KS Natraj, Post Doctoral Trainee1, Rajib De, D.M ( Clinical Hematology )1, Tuphan Dolai, D.M ( Clinical Hematology )1, Malay Ghosh, M.D ( Medicine )1 and Maitreyee Bhattacharyya, D.M. ( Clinical Hematology )2, (1)Hematology, N.R.S Medical College, Kolkata, India, (2)N.R.S Medical College, Kolkata, India

Disclosures:

P. Mandal, None

K. Natraj, None

R. De, None

T. Dolai, None

M. Ghosh, None

M. Bhattacharyya, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.