Descriptive analysis of frequency and antimicrobial susceptibility of pathogens isolated from acute leukemia patients with febrile neutropenia over a four-year period at a tertiary hospital.
1/5 보강
PICO 자동 추출 (휴리스틱, conf 2/4)
유사 논문P · Population 대상 환자/모집단
환자: acute leukemia (AL), which increases the risk of life-threatening infections
I · Intervention 중재 / 시술
추출되지 않음
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
Surveillance of pathogen distribution and resistance patterns is essential to guide empiric therapy and improve outcomes in this high-risk population. [CLINICAL TRIAL NUMBER] Not applicable.
[BACKGROUND] Febrile neutropenia (FN) is a medical emergency in patients with acute leukemia (AL), which increases the risk of life-threatening infections.
APA
Iftekhar A, Zafar A, et al. (2026). Descriptive analysis of frequency and antimicrobial susceptibility of pathogens isolated from acute leukemia patients with febrile neutropenia over a four-year period at a tertiary hospital.. BMC infectious diseases, 26(1). https://doi.org/10.1186/s12879-026-12918-2
MLA
Iftekhar A, et al.. "Descriptive analysis of frequency and antimicrobial susceptibility of pathogens isolated from acute leukemia patients with febrile neutropenia over a four-year period at a tertiary hospital.." BMC infectious diseases, vol. 26, no. 1, 2026.
PMID
41772460
Abstract
[BACKGROUND] Febrile neutropenia (FN) is a medical emergency in patients with acute leukemia (AL), which increases the risk of life-threatening infections. Emerging antimicrobial resistance (AMR) further complicates management. The study aims to identify pathogen frequency and antimicrobial susceptibility patterns.
[METHODS] A retrospective descriptive study was conducted at a tertiary care hospital from January 2020 to December 2023. Data on AL patients with FN were retrieved from the hospital information system using ICD codes.
[RESULTS] Of 478 FN episodes identified, 217 (45%) were microbiologically documented. The population consisted of 61.7% males, equally divided between adults (mean age, 38 years) and children (mean age, 8.4 years). AML was the predominant leukemia subtype (52.4%). Respiratory infections (40.5%) and gastrointestinal infections (33.6%) were the leading sources, with 21% having an unknown focus. Chest X-ray detected infection signs in 37.3% of episodes. Hospital stays exceeded 10 days in 67% of admissions, with mortality at 16.5%. A total of 335 pathogens were identified from 217 episodes, with 20.7% involving multiple infections and 4.6% polymicrobial. Gram-negative rods (GNRs) predominated (45.6%), followed by gram-positive cocci (GPCs) (30.7%), fungi (12.2%), viruses (7%), parasites (2.3%), and (1.7%). Blood cultures yielded 71% of isolates. Leading GNRs were (37.7%), (14.5%), and (13.2%). Among GPCs, (CoNS) (41.1%), (22.5%), and (18.6%) predominated. Common fungal pathogens included Aspergillus flavus complex (29.2%) and (14.6%). Antimicrobial resistance among Enterobacterales was 77% to ceftriaxone, 63% to piperacillin–tazobactam, and 47% to carbapenems. Among GPCs, 95% of CoNS and 72% of S. aureus were methicillin-resistant; 76% of Enterococcus were vancomycin-resistant. Overall, 64% of isolates were MDR (62% GPCs, 65.6% GNRs). MDR infections had significantly higher mortality than non-MDR infections (14.0% vs. 3.5%, = 0.012). Meropenem and vancomycin were the most commonly used empiric agents in FN patients, each administered in 70% of the episodes, however 41% of the FN episodes were not adaequately covered by the empirical regimen.
[CONCLUSION] FN in AL patients is frequently associated with infections with GNRs, with a high prevalence of MDR organisms contributing to increased mortality. Surveillance of pathogen distribution and resistance patterns is essential to guide empiric therapy and improve outcomes in this high-risk population.
[CLINICAL TRIAL NUMBER] Not applicable.
[METHODS] A retrospective descriptive study was conducted at a tertiary care hospital from January 2020 to December 2023. Data on AL patients with FN were retrieved from the hospital information system using ICD codes.
[RESULTS] Of 478 FN episodes identified, 217 (45%) were microbiologically documented. The population consisted of 61.7% males, equally divided between adults (mean age, 38 years) and children (mean age, 8.4 years). AML was the predominant leukemia subtype (52.4%). Respiratory infections (40.5%) and gastrointestinal infections (33.6%) were the leading sources, with 21% having an unknown focus. Chest X-ray detected infection signs in 37.3% of episodes. Hospital stays exceeded 10 days in 67% of admissions, with mortality at 16.5%. A total of 335 pathogens were identified from 217 episodes, with 20.7% involving multiple infections and 4.6% polymicrobial. Gram-negative rods (GNRs) predominated (45.6%), followed by gram-positive cocci (GPCs) (30.7%), fungi (12.2%), viruses (7%), parasites (2.3%), and (1.7%). Blood cultures yielded 71% of isolates. Leading GNRs were (37.7%), (14.5%), and (13.2%). Among GPCs, (CoNS) (41.1%), (22.5%), and (18.6%) predominated. Common fungal pathogens included Aspergillus flavus complex (29.2%) and (14.6%). Antimicrobial resistance among Enterobacterales was 77% to ceftriaxone, 63% to piperacillin–tazobactam, and 47% to carbapenems. Among GPCs, 95% of CoNS and 72% of S. aureus were methicillin-resistant; 76% of Enterococcus were vancomycin-resistant. Overall, 64% of isolates were MDR (62% GPCs, 65.6% GNRs). MDR infections had significantly higher mortality than non-MDR infections (14.0% vs. 3.5%, = 0.012). Meropenem and vancomycin were the most commonly used empiric agents in FN patients, each administered in 70% of the episodes, however 41% of the FN episodes were not adaequately covered by the empirical regimen.
[CONCLUSION] FN in AL patients is frequently associated with infections with GNRs, with a high prevalence of MDR organisms contributing to increased mortality. Surveillance of pathogen distribution and resistance patterns is essential to guide empiric therapy and improve outcomes in this high-risk population.
[CLINICAL TRIAL NUMBER] Not applicable.