Paul Manisha, Bhatia Mohit, Rekha Udayakumar Sasi, Omar Balram Ji, Gupta Pratima
Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
J Lab Physicians. 2020 Aug;12(2):147-153. doi: 10.1055/s-0040-1716661. Epub 2020 Sep 2.
Febrile neutropenia is a serious complication of chemotherapy affecting patients with both hematological and solid malignancies, respectively. To the best of our knowledge, there is paucity of literature from Uttarakhand, India on microbiological profile of blood stream infections (BSIs) in febrile neutropenic patients. The study aims to generate preliminary data on microbiological profile and antibiotic resistance pattern of BSIs in febrile neutropenic patients. The design involved cross-sectional study from January 1, 2019 to July 31, 2019. Data of nonrepetitive paired peripheral blood samples obtained from 306 consecutive febrile neutropenic cancer patients of all age groups and both sexes, for culture and sensitivity testing, were retrospectively analyzed. All blood samples were subjected to aerobic culture using BACT/ALERT three-dimensional microbial detection system. Growth obtained in culture was identified by conventional biochemical methods. Antibiotic susceptibility testing of bacterial isolates was performed using modified Kirby Bauer disk diffusion method. Fisher's exact test was used for the analysis. Mean age ± SD of the study population was 32.39 ± 10.56 years with a male to female ratio of 1.55:1. 74.18% of the blood samples were received from patients suffering from hematological malignancies. Microbiologically confirmed BSIs were observed in 27.1% patients. Gram-negative bacilli were predominantly isolated in culture with . being the most common. Percentage resistance values of gram-negative bacilli to aminoglycosides, β-lactam/β-lactamase inhibitor combinations, fluoroquinolones, cephalosporins, carbapenems, chloramphenicol, ampicillin, co-trimoxazole, and doxycycline were 26.6 to 91.7%, 8.3 to 86.6%, 10 to 66.7%, 13.3 to 73.3%, 8.3 to 73.3%, 80 to 93.3%, 13.3 to 20%, 16.7 to 66.6%, and 13.3 to 16.7%, respectively. Implementation of antimicrobial stewardship program along with hospital infection control practices is needed for preventing BSIs due to MDR organisms.
发热性中性粒细胞减少是化疗的一种严重并发症，分别影响血液系统恶性肿瘤和实体恶性肿瘤患者。据我们所知，印度北阿坎德邦关于发热性中性粒细胞减少患者血流感染（BSIs）微生物学特征的文献较少。 本研究旨在生成发热性中性粒细胞减少患者BSIs微生物学特征和抗生素耐药模式的初步数据。 该设计涉及2019年1月1日至2019年7月31日的横断面研究。 对从306例所有年龄组和性别的连续发热性中性粒细胞减少癌症患者中获得的非重复性配对外周血样本进行培养和药敏试验的数据进行回顾性分析。所有血样均使用BACT/ALERT三维微生物检测系统进行需氧培养。培养中获得的生长物通过常规生化方法进行鉴定。使用改良的 Kirby Bauer 纸片扩散法对细菌分离株进行抗生素敏感性试验。 采用Fisher精确检验进行分析。 研究人群的平均年龄±标准差为32.39±10.56岁，男女比例为1.55:1。74.18%的血样来自血液系统恶性肿瘤患者。27.1%的患者观察到微生物学确诊的BSIs。革兰氏阴性杆菌在培养中占主导地位，其中 最为常见。革兰氏阴性杆菌对氨基糖苷类、β-内酰胺/β-内酰胺酶抑制剂组合、氟喹诺酮类、头孢菌素类、碳青霉烯类、氯霉素、氨苄西林、复方新诺明和强力霉素的耐药百分比分别为26.6%至91.7%、8.3%至86.6%、10%至66.7%、13.3%至73.3%、8.3%至73.3%、80%至93.3%、13.3%至20%、16.7%至66.6%和13.3%至16.7%。 为预防多重耐药菌引起的BSIs，需要实施抗菌药物管理计划以及医院感染控制措施。
