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

摘要

Background: Bacterial bloodstream infections are one of the most common complications in cancer patients undertreatment. Bacteremia in these patients is a medical crisis that needs antibiotic treatment. The aim of this study wasto 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 hospitalin Yazd from 2012 to 2015 were participated. Bacterial pathogens isolated by the BACTEC media and antimicrobialsusceptibility 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 fromhematologic malignancies, and 37.7℅ (80/212) had solid tumors. Gram-negative bacteria were the predominantmicroorganisms (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 isolatedGram-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: Themajority of bacterial pathogens were resistance to various antibiotics. Judicious use of antibiotic therapy can preventthe emergence and spread of antibiotic-resistant Gram-negative bacteria.