BACTERIAL SPECTRUM AND SUSCEPTIBILITY PATTERNS OF PATHOGENS IN ADULT FEBRILE NEUTROPENIC PATIENTS: A COMPARISON BETWEEN TWO TIME PERIODS
AbstractBackground: The aim of this study was to study trends in bacterial spectrum and susceptibilitypatterns of pathogens in adult febrile neutropenic patients during two time periods. Methods: Weretrospectively reviewed the medical records of 379 adult oncology patients admitted withchemotherapy induced febrile neutropenia at our institute during years 2003 and 2006. Results: Atotal of 151 organisms were isolated during the two calendar years. Gram negative bacteriaaccounted for 57.6% of organisms, while gram positive organisms accounted for 42.3% of thetotal isolates. The most common organisms were: Escherichia coli (23.1%), Staphylococcusepidermidis (13.9%), Pseudomonas aeruginosa (12.5%) and Staphylococcus aureus (7.9%). Thenumber of gram positive isolates showed an increase from 35% in 2003 to 47.2% in 2006(p=0.13). During each calendar year, Staphylococcus epidermidis and Staphylococcus aureus were100% susceptible to vancomycin and 33% strains of Staphylococcus aureus were methicillinresistant. Escherichia coli and Pseudomonas aeruginosa strains were highly sensitive topiperacillin/tazobactam and amikacin during both time periods. Resistance of Pseudomonasaeruginosa strains to ciprofloxacin increased from 0% in 2003 to 50% in 2006 (p=0.03).Conclusions: Gram negative organisms are the predominant organisms in adult febrileneutropenic patients at our institute. Initial empirical therapy with piperacillin/tazobactam seemsappropriate to cover most gram negative pathogens while vancomycin to be added for suspectedgram positive infections. During the two calendar years resistance of Pseudomonas aeruginosastrains to ciprofloxacin has significantly increased.Keywords: Bacterial spectrum, Febrile neutropenic patients, Empirical therapy
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