Analysis of pathogens and susceptibility in cancer patients with febrile neutropenia and bacteremia: Experience in a single institution in eastern Taiwan

Kuan Po Huang, Tso Fu Wang, Sung Chao Chu, Yi Feng Wu, Rou Yun Wang, Ruey Ho Kao

Research output: Contribution to journalArticle

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Abstract

Objective: Febrile neutropenia is a major complication in patients with malignancies receiving chemotherapy. The pathogens vary in different geographic areas, however, and also may vary in different institutions. This retrospective study analyzed the profile of bacteria in cases of febrile neutropenia at a single medical center in eastern Taiwan. Materials and Methods: From July 2006 to July 2007, we retrospectively evaluated 80 adult cancer patients who were admitted to the hematology and oncology ward in our hospital because of febrile neutropenia. The clinical characteristics of those who survived (survival group) and those who died (mortality group) were compared. The blood culture data and susceptibility to antibiotics during episodes of febrile neutropenia were obtained for interpretation. Results: Among a total of 110 episodes of febrile neutropenia, 31% had documented bacteremia. The most common malignancy among these patients was acute leukemia (31%), followed by non-Hodgkin's lymphoma and breast cancer. The median time from the start of chemotherapy to febrile neutropenia was shorter in the mortality group than the survival group (8.5 days vs. 11 days; p=0.046). The rate of positive blood cultures was much higher in those who died compared to those who survived (75% vs. 23%, p=0.0001). Gram-negative bacilli were the predominant pathogens in these neutropenic patients, which is different from the trend in Western countries. Infection with Escherichia coli was more common in the survival group and Pseudomonas species were more common in the non-survival group. Gram-positive cocci occurred in similar proportions in both groups. E coli in patients with febrile neutropenia were still susceptible to all first-line antibiotics. Conclusions: Adult cancer patients with febrile neutropenia are at a high risk of mortality, especially those with documented bacteremia and short times between chemotherapy and neutropenia. Gram-negative bacilli are still the predominant pathogens in patients with febrile neutropenia and most are still susceptible to all first-line antibiotics. Further investigation into the relationship between the patterns of different pathogens and mortality in this population is needed.

Original languageEnglish
Pages (from-to)115-118
Number of pages4
JournalTzu Chi Medical Journal
Volume23
Issue number4
DOIs
Publication statusPublished - Dec 1 2011
Externally publishedYes

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Febrile Neutropenia
Bacteremia
Taiwan
Neoplasms
Mortality
Anti-Bacterial Agents
Drug Therapy
Bacillus
Survival
Escherichia coli Infections
Gram-Positive Cocci
Hematology
Pseudomonas
Neutropenia
Non-Hodgkin's Lymphoma
Leukemia
Retrospective Studies
Breast Neoplasms
Escherichia coli
Bacteria

Keywords

  • Antibiotics
  • Bacteremia
  • Febrile neutropenia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Analysis of pathogens and susceptibility in cancer patients with febrile neutropenia and bacteremia : Experience in a single institution in eastern Taiwan. / Huang, Kuan Po; Wang, Tso Fu; Chu, Sung Chao; Wu, Yi Feng; Wang, Rou Yun; Kao, Ruey Ho.

In: Tzu Chi Medical Journal, Vol. 23, No. 4, 01.12.2011, p. 115-118.

Research output: Contribution to journalArticle

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title = "Analysis of pathogens and susceptibility in cancer patients with febrile neutropenia and bacteremia: Experience in a single institution in eastern Taiwan",
abstract = "Objective: Febrile neutropenia is a major complication in patients with malignancies receiving chemotherapy. The pathogens vary in different geographic areas, however, and also may vary in different institutions. This retrospective study analyzed the profile of bacteria in cases of febrile neutropenia at a single medical center in eastern Taiwan. Materials and Methods: From July 2006 to July 2007, we retrospectively evaluated 80 adult cancer patients who were admitted to the hematology and oncology ward in our hospital because of febrile neutropenia. The clinical characteristics of those who survived (survival group) and those who died (mortality group) were compared. The blood culture data and susceptibility to antibiotics during episodes of febrile neutropenia were obtained for interpretation. Results: Among a total of 110 episodes of febrile neutropenia, 31{\%} had documented bacteremia. The most common malignancy among these patients was acute leukemia (31{\%}), followed by non-Hodgkin's lymphoma and breast cancer. The median time from the start of chemotherapy to febrile neutropenia was shorter in the mortality group than the survival group (8.5 days vs. 11 days; p=0.046). The rate of positive blood cultures was much higher in those who died compared to those who survived (75{\%} vs. 23{\%}, p=0.0001). Gram-negative bacilli were the predominant pathogens in these neutropenic patients, which is different from the trend in Western countries. Infection with Escherichia coli was more common in the survival group and Pseudomonas species were more common in the non-survival group. Gram-positive cocci occurred in similar proportions in both groups. E coli in patients with febrile neutropenia were still susceptible to all first-line antibiotics. Conclusions: Adult cancer patients with febrile neutropenia are at a high risk of mortality, especially those with documented bacteremia and short times between chemotherapy and neutropenia. Gram-negative bacilli are still the predominant pathogens in patients with febrile neutropenia and most are still susceptible to all first-line antibiotics. Further investigation into the relationship between the patterns of different pathogens and mortality in this population is needed.",
keywords = "Antibiotics, Bacteremia, Febrile neutropenia",
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T1 - Analysis of pathogens and susceptibility in cancer patients with febrile neutropenia and bacteremia

T2 - Experience in a single institution in eastern Taiwan

AU - Huang, Kuan Po

AU - Wang, Tso Fu

AU - Chu, Sung Chao

AU - Wu, Yi Feng

AU - Wang, Rou Yun

AU - Kao, Ruey Ho

PY - 2011/12/1

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N2 - Objective: Febrile neutropenia is a major complication in patients with malignancies receiving chemotherapy. The pathogens vary in different geographic areas, however, and also may vary in different institutions. This retrospective study analyzed the profile of bacteria in cases of febrile neutropenia at a single medical center in eastern Taiwan. Materials and Methods: From July 2006 to July 2007, we retrospectively evaluated 80 adult cancer patients who were admitted to the hematology and oncology ward in our hospital because of febrile neutropenia. The clinical characteristics of those who survived (survival group) and those who died (mortality group) were compared. The blood culture data and susceptibility to antibiotics during episodes of febrile neutropenia were obtained for interpretation. Results: Among a total of 110 episodes of febrile neutropenia, 31% had documented bacteremia. The most common malignancy among these patients was acute leukemia (31%), followed by non-Hodgkin's lymphoma and breast cancer. The median time from the start of chemotherapy to febrile neutropenia was shorter in the mortality group than the survival group (8.5 days vs. 11 days; p=0.046). The rate of positive blood cultures was much higher in those who died compared to those who survived (75% vs. 23%, p=0.0001). Gram-negative bacilli were the predominant pathogens in these neutropenic patients, which is different from the trend in Western countries. Infection with Escherichia coli was more common in the survival group and Pseudomonas species were more common in the non-survival group. Gram-positive cocci occurred in similar proportions in both groups. E coli in patients with febrile neutropenia were still susceptible to all first-line antibiotics. Conclusions: Adult cancer patients with febrile neutropenia are at a high risk of mortality, especially those with documented bacteremia and short times between chemotherapy and neutropenia. Gram-negative bacilli are still the predominant pathogens in patients with febrile neutropenia and most are still susceptible to all first-line antibiotics. Further investigation into the relationship between the patterns of different pathogens and mortality in this population is needed.

AB - Objective: Febrile neutropenia is a major complication in patients with malignancies receiving chemotherapy. The pathogens vary in different geographic areas, however, and also may vary in different institutions. This retrospective study analyzed the profile of bacteria in cases of febrile neutropenia at a single medical center in eastern Taiwan. Materials and Methods: From July 2006 to July 2007, we retrospectively evaluated 80 adult cancer patients who were admitted to the hematology and oncology ward in our hospital because of febrile neutropenia. The clinical characteristics of those who survived (survival group) and those who died (mortality group) were compared. The blood culture data and susceptibility to antibiotics during episodes of febrile neutropenia were obtained for interpretation. Results: Among a total of 110 episodes of febrile neutropenia, 31% had documented bacteremia. The most common malignancy among these patients was acute leukemia (31%), followed by non-Hodgkin's lymphoma and breast cancer. The median time from the start of chemotherapy to febrile neutropenia was shorter in the mortality group than the survival group (8.5 days vs. 11 days; p=0.046). The rate of positive blood cultures was much higher in those who died compared to those who survived (75% vs. 23%, p=0.0001). Gram-negative bacilli were the predominant pathogens in these neutropenic patients, which is different from the trend in Western countries. Infection with Escherichia coli was more common in the survival group and Pseudomonas species were more common in the non-survival group. Gram-positive cocci occurred in similar proportions in both groups. E coli in patients with febrile neutropenia were still susceptible to all first-line antibiotics. Conclusions: Adult cancer patients with febrile neutropenia are at a high risk of mortality, especially those with documented bacteremia and short times between chemotherapy and neutropenia. Gram-negative bacilli are still the predominant pathogens in patients with febrile neutropenia and most are still susceptible to all first-line antibiotics. Further investigation into the relationship between the patterns of different pathogens and mortality in this population is needed.

KW - Antibiotics

KW - Bacteremia

KW - Febrile neutropenia

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