Sites of Infections and Types of Organisms in Patients with Febrile Neutropenia in Hematological Ward in Civil Service Hospital

Abstract

Introduction: The risk of developing a significant infection increases as the neutrophil count falls below 500 cells/µL, particularly in cases of prolonged neutropenia lasting more than seven days. The site of infections and organisms causing those infections
are helpful in diagnosis and that ultimately helps in judicial use of antimicrobials and helps to prevent antimicrobials resistant.

Objective: The objective of the study was to document the current sites of infection in patients with febrile neutropenia, pattern of bacterial growth and antibiotic susceptibility.

Methods: A prospective observational study was conducted from August 2023 to July 2024 at Civil Hospital, Kathmandu. A total 108 neutropenic cases with positive culture were enrolled in this study. This study involved a comprehensive evaluation of patients admitted to the Hematology Department, focusing on demographic and clinical data collection.

Results: Mean age of presentation was 31.96 years. Acute Myeloid Leukemia (52.8%) and Acute Lymphocytic Leukemia (21.3%) were the most common underlying hematological disorder, followed by Aplastic Anemia (13.9%), Multiple Myeloma (5.6%), Non-Hodgkin Lymphoma (4.6%), and Hodgkin Lymphoma (1.8%). Urine Samples yield the highest percentages of culture positivity (52%) followed by blood sample (18%). Gram-negative bacteria yield the highest positivity of 98.1% among which Escherichia coli(E-Coli) being the most common with 44.4% positivity followed by Kleibsella which was isolated in 38.9% of sample.

Conclusions: The Urinary Tract Infection(UTI) is most common site of infection, Gram-Negative microorganisms (98.1%) being the frequent cause. Female are more prone to have UTI. E-coli being the most common infecting microorganism.