Universal Journal of Public Health Vol. 5(4), pp. 172 - 175
DOI: 10.13189/ujph.2017.050406
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Bacteremia Pattern in Febrile Neutropenia among Adults Cancer Patients Receiving Chemotherapy in an Australia Regional Hospital

Tunde Maiyaki Ibrahim ^1,2,*, Christine Pang ^1
1 Department of Medicine, Goulburn Valley Base Hospital, Graham Street Shepparton, Victoria, Australia
² Clinical Rural School of Medicine, The University of Melbourne, Graham Street, Victoria, Australia

ABSTRACT

Background: Febrile neutropenia (FN) remains one of the most concerning complications of cancer chemotherapy, and is a major cause of morbidity and mortality, consuming significant healthcare resource .This audit was carried out to determine the pattern of microbial pathogens responsible for FN in our institution as this will result in the appropriate choice of empirical antibiotic(s) for treatment of FN in the future. Methods: This is a retrospective audit of adult patients with cancer admitted with FN post chemotherapy in Goulburn valley base hospital, Shepparton, Australia between 2011- 2013.Only patients who met the diagnostic criteria of FN as defined by the Infectious diseases society of America (IDSA) were included in the audit. Results: Twenty six patients presented with 31 episodes of FN between January 2013 and January 2014. 65 blood cultures (BC) were obtained with an average of 2.5 sets of BC per patients, 10.8% of these were positive. 66.7% of the BC yielded Gram Positive Cocci (GPC) (50% of which were coagulase positive staphylococci), 33.7% of the BC yielded gram negative bacilli (GNB) and 2 yielded multiple organisms. The mean neutrophil count on admission for all the 26 patients was 0.303 ± 0.25/ul. Those with positive BCs had significantly higher hs-CRP with the mean value of 223.83±94.27 mg/l, compared to those with negative BCs with 89.37±79.53 mg/l (t-test = -3.489, p=0.002).The most common malignancies were hematological and breast cancers with 8 patients each. The presumed focus of infection was mostly in the respiratory tract accounting for 42% of the cases. 30.8% of the 26 patients with FN had central venous access device(CVAD) in-situ but all had negative BCs however the odd ratio of developing FN if CVAD is present is high at 4.3(95% CI 1.01-18.0). Conclusions: the prevalence rate of bacteremia in post chemotherapy FN in our center is relatively low and GPC are the most commonly isolated organisms. Our study also support the notion that hs-CRP may be a sensitive biomaker of bacterial infection in cancer patients with post chemotherapy FN as it is significantly higher in those with positive BC.

KEYWORDS
Febrile Neutropenia, Cancer Patients, Blood Cultures, Chemotheraphy

Cite This Paper in IEEE or APA Citation Styles
(a). IEEE Format:
[1] Tunde Maiyaki Ibrahim , Christine Pang , "Bacteremia Pattern in Febrile Neutropenia among Adults Cancer Patients Receiving Chemotherapy in an Australia Regional Hospital," Universal Journal of Public Health, Vol. 5, No. 4, pp. 172 - 175, 2017. DOI: 10.13189/ujph.2017.050406.

(b). APA Format:
Tunde Maiyaki Ibrahim , Christine Pang (2017). Bacteremia Pattern in Febrile Neutropenia among Adults Cancer Patients Receiving Chemotherapy in an Australia Regional Hospital. Universal Journal of Public Health, 5(4), 172 - 175. DOI: 10.13189/ujph.2017.050406.