scholarly journals Clinical and Microbiological Profile of Pathogens in Febrile Neutropenia in Hematological Malignancies: A Single Center Prospective Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
M. Taj ◽  
T. Farzana ◽  
T. Shah ◽  
S. Maqsood ◽  
S. S. Ahmed ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Empirical Treatment ◽  
First Line ◽  
Gram Positive ◽  
Gram Negative ◽  
Hematological Disorders ◽  
Microbiological Profile ◽  
Sensitivity Pattern ◽  
Culture Sensitivity ◽  
Marked Decline

Background. Febrile neutropenia is the consequence of treatment of hematological disorders. The first-line empirical treatment should cover the prevalent microorganism of the institute. The aim of study was to establish the effectiveness of current practices used at the institution and to review the culture sensitivity pattern of isolated microorganisms.Patients and Methods. Data was recorded and analyzed prospectively for 226 hospitalized patients of febrile neutropenia from January 2011 till December 2013.Results. Out of 226 cases, 173 were males and 53 were females. Clinically documented infections were 104 (46.01%) and microbiologically documented infections were 80 (35.39%), while 42 (18.58%) had pyrexia of undetermined origin. Gram negative infections accounted for 68 (85%) andEscherichia coliwas the commonest isolate. Gram positive microorganisms were isolated in 12 (15%) cases and most common wasStaphylococcus aureus. First-line empirical treatment with piperacillin/tazobactam and amikacin showed response in 184 patients (85.9%) till 72 hours.Conclusion. There is marked decline in infections due to Gram positive microorganisms; however, Gram negative infections are still of great concern and need further surveillance. In this study the antibiogram has shown its sensitivity for empirical antibiotic therapy used; hence, it supports continuation of the same practice.

scholarly journals Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk Patients

2015 ◽  
Vol 7 (02) ◽  
pp. 116-120 ◽  
Author(s):  
Kuntegowdanahalli C Lakshmaiah ◽  
Abhayakumar S Malabagi ◽  
Rachan Shetty ◽  
Mahua Sinha ◽  
Rudrapatna S Jayashree ◽  
...  
Keyword(s):  
High Risk ◽  
Febrile Neutropenia ◽  
Hematological Malignancies ◽  
Hematologic Malignancies ◽  
First Line ◽  
Gram Negative ◽  
Microbiological Profile ◽  
Satisfactory Outcome ◽  
Sensitivity Pattern ◽  
Empiric Antibiotic

ABSTRACT Background and Objectives: Febrile neutropenia (FN) is considered a medical emergency. Patients with hematological malignancies (HM) commonly experience FN. Broad spectrum antibiotics have to be started empirically to prevent complications. This study depicts the clinical profile, microbiological profile, antibiotic sensitivity pattern, and outcome in high risk HM. Materials and Methods: In this prospective study, 72 patients with hematologic malignancies, diagnosed and treated for 108 high risk febrile neutropenic episodes from August 2011 to January 2013 at a Regional Cancer Center, in South India were analyzed. Cefoperazone-sulbactum was used as a first-line empiric antibiotic. Results: Majority of the patients with FN episodes had acute myeloid leukemia. Overall culture positivity was 29.62%. The most common organisms isolated were Gram-negative bacilli (63.64%), with Escherichia coli being the most frequent pathogen. All Gram-negative organisms were sensitive to imipenem, whereas sensitivity pattern to other antibiotics were as follows: 85.71%, 78.26%, 69.52%, 63.64%, 41.66% and 47.05% for pipercillin-tazoactum, meropenem, cefoperazone-sulbactum, amikacin, ceftazidime, ciprofloxacin respectively. Overall mortality was 13.5%. Most of the patients responded to empiric antibiotic cefoperazone-sulbactum. Conclusions: In the hematologic malignancies particularly in acute leukemia, there is high risk of developing FN. Empiric therapy with cefoperazone-sulbactum as a first line leads to satisfactory outcome in high risk FN and therapy should be tailored to the most appropriate antibiotics according to the bacterial culture results.

scholarly journals NEW INSIGHT ON EPIDEMIOLOGY AND MANAGEMENT OF BACTERIAL BLOODSTREAM INFECTION IN PATIENTS WITH HEMATOLOGICAL MALIGNACIES

2015 ◽  
Vol 7 ◽  
pp. e2015044 ◽  
Author(s):  
Sara Lo Menzo ◽  
Giulia La Martire ◽  
Giancarlo Ceccarelli ◽  
Mario Venditti
Keyword(s):  
Febrile Neutropenia ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Empirical Treatment ◽  
Rational Approach ◽  
Attributable Mortality ◽  
Low Grade ◽  
Gram Positive ◽  
Adequate Treatment ◽  
Gram Negative

Bloodstream infections (BSI) are an important cause of morbidity and mortality in onco-hematologic patients. The Gram-negative etiology was the main responsible of the febrile neutropenia in the sixties and its impact declined due to the use of fluoroquinolone prophylaxis; this situation was followed by the gradual emergence of Gram-positive bacteria also following of the increased use of intravascular devices and the introduction of new chemotherapeutic strategies. In the last decade the Gram-negative etiology is raising again because of the emergence of resistant strains that make questionable the usefulness of currentstrategies for prophylaxis and empirical treatment. Gram-negative BSI attributable mortality is relevant and the appropriate empirical treatment significantly improves the prognosis; on the other hand the delayed adequate treatment of Gram-positive BSI does not seem to have an high impact on survival. The clinician has to be aware of the epidemiology of his institution and of colonizations of his patients in order to choose the most appropriate empiric therapy. Ina setting of high endemicity of multidrug-resistant infections, even the choice of a targeted therapy can be a challenge, often requiring strategies based on off-label prescriptions and low grade evidences.In this review we summarize the current evidences for the best targeted therapies for difficult to treat bacteria BSIs and future perspectives in this topic. We also provide a flow chart for a rational approach to the empirical treatment of febrile neutropenia in a multidrug resistant high prevalence setting.

scholarly journals Incidence of central venous and Foley’s catheter related bacteraemia, organisms responsible and antibiotic sensitivity pattern: in cardio-thoracic intensive theraputic unit following elective surgery, in a tertiary care hospital of Kolkata, India

2020 ◽  
Vol 7 (6) ◽  
pp. 893
Author(s):  
Swarnendu Datta ◽  
Ushnish Chakrabarty ◽  
Priyanka Chakrabarty ◽  
Plaban Mukherjee
Keyword(s):  
Blood Stream Infection ◽  
Antibiotic Sensitivity ◽  
Blood Stream ◽  
Care Hospital ◽  
Central Venous ◽  
Gram Positive ◽  
Gram Negative ◽  
Sensitivity Pattern ◽  
Culture Sensitivity ◽  
Foley’S Catheter

Background: Mortality from bacteraemia related to indwelling Central Venous Pressure (CVP) lines could be as high as 12 - 25% and that due to indwelling urinary catheters about 5%, in critically ill patients. Hence, initiation of early and aggressive antibiotic therapy, often even before the culture- sensitivity reports are available is necessary. Objectives of the study was to find out the incidence of bacteraemia  related to indwelling CVP catheters &/or Foley’s catheters in post operative patients in Cardio-thoracic  Intensive Theraputic Unit (ITU) and to understand the antibiotic sensitivity patterns against the organisms causing such bacteraemiaMethods: 48 hours after their insertion, CVP catheter tips, Foley’s catheter tips and Peripheral blood samples were collected for cultures in 50 patients who underwent elective cardiothoracic surgery, over a period of one year and results were interpreted.Results: Incidence of bacteraemia associated with indwelling CVP catheters was 8% and was caused by both - Gram positive (Staphylococcus aureus, Enterococcus faecium) and Gram negative (Acinetobacter baumanii, Pseudomonas aeruginosa) organisms. Foley’s catheter was not related to such blood stream infection.  Vancomycin and Linezolid were effective against the Gram positive organisms; while Piperacillin- Tazobactam, Meropenem, Polymyxin B and Colistin were effective against the Gram negative organisms.Conclusions: Indwelling CVP catheters were associated with blood stream infection in 4 post operative patients in our ITU. An idea about the organisms responsible, as well as their antibiogram may help in early initiation of antibiotics empirically before culture-sensitivity reports are available.

scholarly journals Retrospective Analysis of Bacterial Isolates during Blood Stream Infections in Children with Chemotherapy-induced Febrile Neutropenia: A Single Centre Experience

2021 ◽  
Author(s):  
Abhilasha Sampagar ◽  
B R Ritesh ◽  
Dubey Shiv ◽  
Shridhar C. Ghagne ◽  
Neha Patil ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Burkholderia Cepacia ◽  
Bacterial Infections ◽  
Limiting Factor ◽  
Induction Phase ◽  
Gram Positive ◽  
Gram Negative ◽  
Sensitivity Pattern ◽  
Tertiary Center ◽  
Pediatric Cancer Patients

Abstract Introduction The recent advances in cancer treatment have resulted in significant improvement in the outcome of pediatric cancers. However, febrile neutropenia (FN) is the most important cause of mortality and morbidity in pediatric cancer patients and is a crucial limiting factor for the outcome. The greatest threat that we are facing is the emergence of pan drug-resistant (PDR) organisms. Objectives To study bacterial organisms causing bloodstream infections (BSI) during febrile neutropenia episodes, their antibiotic sensitivity pattern, impact on treatment outcome during the intensive phase of chemotherapy, and the association between prior administration of antibiotics and emergence of multidrug-resistant organisms (MDR). Materials and Methods This retrospective study was conducted in patients between the age group of 0 to 18 years who were treated for malignancies in the division of pediatric oncology at a tertiary center from August 2017 to December 2020. Blood cultures were collected under aseptic precautions, and they were processed as per the Clinical and Laboratory Standard Institute Guideline (CLSI) 2017. Results A total of 122/159 (76.7%) patients were diagnosed to have hematological malignancies, and 37/159 (23.3%) patients were found to be suffering from solid tumors. A total of 309 episodes of FN were documented and 386 cultures were sent, out of which 87/386 (22.53%) cultures were positive for bacteria and 2/386 (2.2%) for fungi. Gram-negative isolates were seen in 51/87 (58.62%) cultures and Gram-positive in 36/87 (41.37%) cultures. Burkholderia cepacia and coagulase-negative Staphylococci (CONS) were the commonest found Gram-negative and Gram-positive bacteria, respectively. MDR bacterial strains were seen in 44/87 (50.57%) cultures and PDR strains in 8/87 (9.2%) cultures. Resistance was higher with Klebsiella species and CONS. There were six mortalities during the induction phase of acute leukemia treatment, out of which 4/6 (66.66%) were due to MDR infections, 1/6 (16.6%) due to fungal infection and chemotherapy refractoriness each. Conclusion Proven bacterial infections were determined in 22.53% of febrile neutropenia episodes. Most BSI in patients with febrile neutropenia were caused by Gram-negative bacteria. Indiscriminate use of higher antibiotics before referral led to the emergence of MDR organisms, thus compromising the outcome. Our study emphasizes the fact that antibiotic stewardship is a crucial task to counter MDR bacteremia-related morbidity and mortality in neutropenic children.

Microbial Infection with Their Antibiotic Sensitivity Pattern in Febrile Neutropenic Patients Treated in Haematology and BMT Unit in DMCH

2018 ◽  
Vol 2 (02) ◽  
pp. 42-46
Author(s):  
Md. Ashraful Haque Chowdhury ◽  
Akhil Ranjan Biswas ◽  
Salma Afrose ◽  
Mafruha Akhter ◽  
Tasneem Ara ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Medical College Hospital ◽  
Urine Samples ◽  
Gram Positive ◽  
College Hospital ◽  
Gram Negative ◽  
Medical College ◽  
Sensitivity Pattern ◽  
Neutropenic Patients ◽  
Blood And Urine Samples

Background: Because of great concerns about mortality and morbidity due to infection in febrile neutropenic patients, the appropriate empirical antibiotic should be started immediately. Although there are established guidelines for the use of empirical therapy in febrile neutropenia, local microbiological pattern and antibiotic susceptibility should be considered for better outcome. There is paucity of data regarding the organism isolated and sensitivity in febrile neutropenic patients in Dhaka Medical College Hospital (DMCH). Objectives: The current study aimed to find out causative organisms for febrile neutropenia and to observe their antimicrobial sensitivity pattern. Materials and method:  This was a prospective observational study carried out in department of haematology and BMT of Dhaka Medical college hospital during the period of October, 2014 to July, 2015. Total 104 patients experienced febrile neutropenia and both febrile blood and urine samples were collected and sent for culture. Results: Out of 104 patients male were 65 and female were 39 (M:F ratio 1.6:1) with a mean age of patients were 31.3 (±15.43) years. Majority (86.5%) of febrile neutropenic patients were post-chemotherapy of acute leukaemia. Out of 104 case 29 were positive growth in both blood and urine samples. Out of 25 blood culture positive patients’ organisms isolated were predominantly gram negative (78.6%) whereas 21.4% were gram negative.  However, in urine culture equal number of organisms (4 vs 4) from both gram positive and gram negative were isolated. Gram negative microorganisms were resistance to antibiotic such as amoxicillin, ceftazidime, ceftriaxone, cefixime, cotrimoxazole and gentamicin and sensitive to antibiotic like meropenem, amikacin, ciprofloxacin and colistin. Gram positive microorganisms were almost resistance to azithromycin, cefixime, ciprofloxacin, cotrimoxazole, gentamicin and moxifloxacin but were sensitive to chloramphenicol, clindamycin and linezolid. Conclusions: Gram negative organisms were the predominant organisms in febrile neutropenic patients at our institute. They are resistant to a good number of commonly used antibiotics and sensitive to only a few antibiotics.

Fusogenic porous silicon nanoparticles as a broad-spectrum immunotherapy against bacterial infections

2021 ◽  
Author(s):  
Byungji Kim ◽  
Qinglin Yang ◽  
Leslie W. Chan ◽  
Sangeeta N. Bhatia ◽  
Erkki Ruoslahti ◽  
...  
Keyword(s):  
Porous Silicon ◽  
Broad Spectrum ◽  
Therapeutic Efficacy ◽  
Bacterial Infections ◽  
Silicon Nanoparticles ◽  
First Line ◽  
Gram Positive ◽  
Gram Negative ◽  
Porous Silicon Nanoparticles

RNAi-mediated immunotherapy provided by fusogenic porous silicon nanoparticles demonstrates superior therapeutic efficacy against both Gram-positive and Gram-negative bacterial infections compared with first-line antibiotics.

scholarly journals Clinico-bacteriological profile of neonatal sepsis

2019 ◽  
Vol 6 (2) ◽  
pp. 796 ◽  
Author(s):  
Rashmi P. ◽  
Praveen B. K.
Keyword(s):  
Neonatal Sepsis ◽  
Clinical Suspicion ◽  
Coagulase Negative Staphylococcus ◽  
Gram Positive ◽  
Gram Negative ◽  
Methicillin Resistant ◽  
Early Onset Sepsis ◽  
Sensitivity Pattern ◽  
Gram Negative Organisms ◽  
Culture Positive

Background: Neonatal sepsis is the commonest cause of neonatal mortality responsible for about 30-50% of total neonatal deaths in developing countries. Surveillance of causative organisms and their antibiotic sensitivity pattern promotes rational use of antibiotics and antibiotic stewardship.Methods: A retrospective study, relevant data regarding the neonates diagnosed with culture positive sepsis was obtained from the case records during the period from July 2014 to June 2017. Culture positive sepsis was defined as isolation of bacterial pathogen from blood in neonates with clinical suspicion of sepsis.Results: Of the 414 neonates with clinical suspicion of sepsis, 110 neonates had blood culture positive sepsis. Sepsis was predominant in males (64.5%). Low birth weight (47.2%) and prematurity (40.9 %) were important neonatal risk factors for sepsis. Early onset sepsis occurred in 58.1% of the cases and late onset sepsis in 41.9% of the neonates. Gram-positive cocci constituted 67.52% of all isolates and gram negative 30.76%. The most frequently isolated organism in blood was methicillin resistant coagulase negative staphylococcus(MRCONS) (32.47%). Gram positive organisms included MRCONS, methicillin resistant Staphylococci aureus (MRSA), group B Streptococci (GBS), Staphylococcus aureus and Enterococci. Among Gram-negative organisms, Acinetobacter was most frequently isolated followed by Klebsiella, Escherichia coli, Pseudomonas, Citrobacter and Burkholderia species. The mortality in the study group was 13.5%. Gram negative organisms were most resistant to ampicillin and cephalosporins. Gram positive isolates were least resistant to vancomycin and linezolid.Conclusions: Gram positive sepsis was the most common type of sepsis among the neonates, although mortality was more in gram negative sepsis.

scholarly journals Bacteriological Spectrum and Antimicrobial Sensitivity of Pathogens In Children with Hematologic Malignancies and Febrile Neutropenia Research

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Anahita Sanaei Dashti ◽  
Jabarali Safaei ◽  
Fariba Shirvani ◽  
Mohammad Rahim Kadivar ◽  
Erfan Taherifard
Keyword(s):  
Febrile Neutropenia ◽  
Hematologic Malignancies ◽  
Cross Sectional Study ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococci ◽  
Cross Sectional ◽  
Gram Negative ◽  
Antimicrobial Sensitivity ◽  
Demographic Questionnaire ◽  
Sensitivity Pattern

Objectives: This study aimed to investigate the spectrum of bacterial pathogens and their antimicrobial sensitivity in pediatric patients admitted with febrile neutropenia (FN) and hematologic malignancies. Methods: This prospective, cross-sectional study was carried out on 65 children (60% boys, mean age 7.3 5.3 years) with hematologic malignancies and FN hospitalized at the Amir Hematology and Oncology Hospital, Shiraz, Iran, between December 2018 and May 2019. Samples were taken from blood, nose, axilla, and inguinal area (NAI). NAI cultures were repeated after 72 hours of admission, and blood culture was repeated if needed. A demographic questionnaire on age, sex, and admission time was filled out for each patient. Results: The most common grown bacteria in the NAI samples were coagulase-negative staphylococci (CoNS). Second cultures from these sites revealed nosocomial contamination. Eighteen patients (27.7%) had positive blood cultures, with 61.1 % of the isolated pathogens being Gram-negative (mostly Escherichia coli and Pseudomonas aeroginosa) and 38.9% Gram-positive. The blood cultures results did not match those of the NAI cultures in 61.1% of the patients. About one-fourth of the Gram-negative pathogens isolated from blood were resistant to cefepime, the main empirical antibiotic for FN management at our center. Conclusions: Gram-negative bacteria are predominant organisms in pediatric FN patients at our center, most resistant to cefepime. If a similar antimicrobial sensitivity pattern is observed in future studies, a change in local guidelines might be considered for FN management.

scholarly journals Antimicrobial sensitivity pattern from clinical isolates at a tertiary care teaching hospital of rural Bengal: a pilot study

2019 ◽  
Vol 8 (6) ◽  
pp. 1196
Author(s):  
Tapashi Ghosh ◽  
Sabyasachi Saha ◽  
Ananya Mandal ◽  
Nikhil Tudu ◽  
Jayanta Bikash De
Keyword(s):  
Blood Culture ◽  
Clinical Isolates ◽  
Prescribing Patterns ◽  
Gram Positive ◽  
Gram Negative ◽  
Wound Swab ◽  
Antimicrobial Sensitivity ◽  
Sensitivity Pattern ◽  
The Common ◽  
Gram Negative Organisms

Background: Antimicrobial sensitivity pattern from clinical isolates can reveal important information that can help in drafting the hospital antibiotic policy as well as help improve prescribing patterns and patient outcome in a particular region.Methods: Data from the results of the antimicrobial sensitivity pattern of clinical isolates of the patients between 1stJuly and 31st December 2018 were collected on a pre-designed and pre tested case study form and analysed with the help of descriptive statistics.Results: A total of 75 blood culture reports were obtained which showed 58 gram positive cultures. Further 46 of the gram positive samples were positive for Coagulase negative Staphylococcus. A total of 305 urine samples were obtained for culture which showed gram negative cultures. Paediatric and medicine wards were the common yielding sites. A total of 242 pus reports were obtained which showed 47 gram positive cultures. A total of 154 wound swab samples were obtained which showed 47 gram positive cultures. For pus and wound swab samples, surgery wards were the common yielding sites. Common gram negative organisms seen were Klebsiella sp., E. coli, Citrobacter sp., Pseudomonas, Proteus and Enterobacter. Gram positive organisms were commonly resistant to Erythromycin, orally active Penicillins, Vancomycin and Teicoplanin and gram negative organisms were commonly resistant to Cephalosporins, Aminoglycosides, Colistin, Fluroquinolones and Meropenem.Conclusions: This study showed that over six months samples of body pus, wound swab, blood culture and urine showed high levels of resistance to commonly used antibiotics. This would provide an outline for development of an effective hospital Infection Control Policy.

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