Febrile neutropenia in patients with haematological malignancies
Abstract number: P1753
Pouli A., Sotiropoulos D., Manaka A., Petrikkos L.G., Syrigou A., Kotsopoulou M., Pagoni M., Rekleiti A., Sioni A., Symeonidis A., Katodritou E., Hatzihannas L., Neokleous N., Mitsouli X., Nikiforakis E., Anagnostopoulos A., Daikos G.L., Petrikkos G.
Aim: The aim of this study was to evaluate the incidence of infection in neutropenic patients with haematological malignancies in a prospective study in 7 haematological centres.
Patients/methods: We enrolled neutropenic patients (neutrophil count, ANC 500/mm3) due to chemotherapy. We recorded: fever >38°C, disease, chemotherapy, duration of neutropenia, growth factor (G-CSF), chemoprophylaxis, antibiotics, conditions of hospitalisation, Central Venus Catheter (CVC), isolated bacteria and resistance to antibiotics.
Results: We studied 892 cases of neutropenia in 581 patients. In 305 cases there was a CVC. G-CSF was administered in 725 cases. Chemoprophylaxis was administered in 510 cases. The median duration of neutropenia was 14 days. In 672 cases, one or more fever waves have been observed. 51 patients died due to the infection (8.8%). The existence of CVC was significant for the incidence of fever (85% vs 70% p < 0.01) while the administration of G-CSF was not (74% vs 79%, p=ns). The nadir of the ANC was statistical significant (84.4% for ANC 100/mm3 vs 53.5% for ANC > 100/mm3, p < 0.01). Bacteria were isolated in 559 of the febrile cases (62%). The ratio of Gram(+) bacteraemia to Gram(-) was 10 to 6. 30% of Enterococci were resistant to glycopeptides. The percentage of resistance of Pseudomonas sp. in carbapenems was also high (50%). Resistance of Enterobacteriacae to carbapemens is alarmingly increasing (812%).
Conclusions: Febrile neutropenia is the major complication in neutropenic patients with haematological malignancies. Our data showed a statistical significant difference for patients with CVC and with ANC 100/mm3. There was no statistical significant difference for patients receiving G-CSF, chemoprophylaxis and there was no correlation to the duration of neutropenia and to HEPA filter rooms. The mortality due to infection was low.
|Session name:||19th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Helsinki, Finland, 16 - 19 May 2009|
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