Clinical and microbial features of the episodes of febrile neutropenia in acute leukemia patients

Abstract

Infections are the major causes of morbidity and mortality in acute leukemia patients. We retrospectively analyzed the episode of febrile neurtopenia in acute leukemia patients. This study included 50 patients. Median neutropenia duration was 15 day. Bacteremia was confirmed in 27 episodes (54%) of which 15 (56%) were caused by Gram-negative bacilli and 12 (44%) by Gram-positive cocci. The predominant organisms were: E.coli (8), Coagulase negative staphylococci (7), Enterecoccia (6), Staphylococcus aereus (6), Candida (3). In eleven episodes (22%) clinical infections were diagnosed. All patients were started empirically on antibacterial agents. A combination of betalactums and aminoglycoside were used in 15 episodes. Antifungal therapy with amphotericin B (18) or fluconazole (6) was added because of persistent fever despite broad antibacterial coverage. Six patients died (12%) of infections complications in this study. Our results show that infections with Gram-negative bacteria continue to predominate. A trend toward a higher mortality of infections caused by Gram-positive cocci and pneumonia were noted.