Bacterial Spectrum and Antimicrobial Resistance Pattern in Cancer Patients with Febrile Neutropenia

Document Type: Research Articles

Authors

1 Department of Internal Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

2 Department of Pathology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

3 Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.

4 Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.

5 Infectious and Tropical Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

6 Aliebn- Abitaleb School of Medicine, Islamic Azad University, Yazd Branch, Yazd, Iran

Abstract

Background: Bacterial bloodstream infections are one of the most common complications in cancer patients under
treatment. Bacteremia in these patients is a medical crisis that needs antibiotic treatment. The aim of this study was
to determine bacterial spectrum and antimicrobial resistance pattern in febrile neutropenic cancer patients. Methods:
In this prospective study, 212 cancer patients with febrile neutropenia who were referred to Shahid Sadoughi hospital
in Yazd from 2012 to 2015 were participated. Bacterial pathogens isolated by the BACTEC media and antimicrobial
susceptibility tests performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results:
The mean age of patients was 43.5 ± 24.98 years old. Out of 212 participants, 62.3℅ (132/212) were suffering from
hematologic malignancies, and 37.7℅ (80/212) had solid tumors. Gram-negative bacteria were the predominant
microorganisms (84.9℅). E.coli was the most frequently isolated pathogen (38.68 %), followed by Klebsiella
(14.15℅) and Acinetobacter species (11.32℅). In addition, Staphylococcus epidermidis was the most common isolated
Gram-positive bacteria (8.5℅). Gram-negative bacteria were susceptible to ciprofloxacin with a response range of 53.7%
to 100%. The majority of E.coli isolates were sensitive to ceftazidime (87.8℅) and were resistance to Co-trimoxazole
(15.8℅). Klebsiella isolates were 100% susceptible to cephalosporins, meropenem and imipenem. Conclusion: The
majority of bacterial pathogens were resistance to various antibiotics. Judicious use of antibiotic therapy can prevent
the emergence and spread of antibiotic-resistant Gram-negative bacteria.

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