Evaluation of febrile neutropenic patients hospitalized in a hematology clinic
Authors: Mücahit Görük, Mehmet Sinan Dal, Tuba Dal, Abdullah Karakus, Recep Tekin, Nida Özcan, Orhan Ayyildiz
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To evaluate the febrile neutropenic patients with hematological malignancies hospitalized in hematology clinic with poor hygiene standards.
A total of 124 patients with hematological malignancies (69 male, 55 female) hospitalized in hematology clinic with poor hygiene conditions depending on hospital conditions, between January 2007 and December 2010, were evaluated, retrospectively.
In this study, 250 febrile neutropenia episodes developing in 124 hospitalized patients were evaluated. Of the patients, 69 were men (56%) and 55 women (44%). A total of 40 patients (32%) had acute myeloid leukemia, 25 (20%) acute lymphoblastic leukemia, 19 (15%) non-Hodgkin's lymphoma, 10 (8%) multiple myeloma, and 8 (8%) chronic myeloid leukemia. In our study, 56 patients (22%) were diagnosed as pneumonia, 38 (15%) invasive aspergillosis, 38 (15%) sepsis, 16 (6%) typhlitis, 9 (4%) mucormycosis, and 4 (2%) urinary tract infection. Gram-positive cocci were isolated from 52% (n = 20), while Gram-negative bacilli 42% (n = 16) and yeasts from 6% (n = 2) of the sepsis patients, respectively. The most frequently isolated Gram-positive bacteria were methicillin-resistant coagulase-negative staphylococci (n = 18), while the most frequently isolated Gram-negative bacteria was Escherichia coli (n = 10).
Febrile neutropenia is still a problem in patients with hematological malignancies. The documentation of the flora and detection of causative agents of infections in each unit would help to decide appropriate empirical therapy. Infection control procedures should be applied for preventing infections and transmissions.