Darakhshandeh Ali, Fathi Elham, Haji Gholami Ali, Ashrafi Farzaneh, Mehrzad Valiollah, Nasri Elahe
Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.
Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences Isfahan, Iran.
Int J Biochem Mol Biol. 2023 Feb 15;14(1):10-16. eCollection 2023.
Bloodstream infections are serious complications in neutropenic cancer patients. There has been a universal pickup in multidrug resistant (MDR) strains. For individuals who are at high risk for infections caused by MDR bacteria, a novel de-escalation strategy has been developed. Determine the bacterial spectrum and antibiotic resistance pattern in febrile neutropenic cancer patients was the goal of this investigation.
From 2019 to 2020, 60 cancer patients with febrile neutropenia who were sent to Isfahan's Omid Hospital were included in this retrospective analysis. Experiments were done on the antimicrobial susceptibility of isolated bacterial infections.
The patients' average age was 43.35±15.59 years. Ninety-one percent (55/61) of the 60 patients had hematologic malignancies, and 8.3 percent (5/61) had solid tumors. The majority of the germs were gram-negative bacteria (66.7 percent). E. coli was the pathogen that was isolated the most frequently (26.7%), followed by Klebsiella (16.7 percent). In addition, the most prevalent identified Gram-positive bacteria was Staphylococcus epidermidis (21.7 percent). Third-generation cephalosporin (ESBL-E) resistance was present in 50% of E. coli, along with 50% resistance to cotrimoxazole, ciprofloxacin, and piperacillin, 31% resistance to amikacin, and 20% resistance to meropenem (CRE). They had an 80% sensitivity to amikacin and a 70% sensitivity to ciprofloxacin. Ten percent of our patients had antibiotic resistance in the antibiogram (XDR).
In summary, most bacterial infections were resistant to different medications. The emergence and spread of Gram-negative bacteria that are resistant to antibiotics can be stopped by prudent antibiotic use.
血流感染是中性粒细胞减少的癌症患者的严重并发症。多重耐药（MDR）菌株普遍增多。对于有感染耐多药细菌风险的个体，已制定了一种新的降阶梯策略。本研究的目的是确定发热性中性粒细胞减少癌症患者的细菌谱和抗生素耐药模式。
2019年至2020年，60例发热性中性粒细胞减少的癌症患者被送往伊斯法罕的奥米德医院，纳入本回顾性分析。对分离出的细菌感染进行了抗菌药敏试验。
患者的平均年龄为43.35±15.59岁。60例患者中有91%（55/61）患有血液系统恶性肿瘤，8.3%（5/61）患有实体瘤。大多数细菌为革兰氏阴性菌（66.7%）。大肠杆菌是最常分离出的病原体（26.7%），其次是克雷伯菌（16.7%）。此外，最常见的革兰氏阳性菌是表皮葡萄球菌（21.7%）。50%的大肠杆菌对第三代头孢菌素（ESBL-E）耐药，同时对复方新诺明、环丙沙星和哌拉西林耐药率为50%，对阿米卡星耐药率为31%，对美罗培南（CRE）耐药率为20%。它们对阿米卡星的敏感性为80%，对环丙沙星的敏感性为70%。10%的患者在抗菌谱中存在抗生素耐药（XDR）。
总之，大多数细菌感染对不同药物耐药。谨慎使用抗生素可阻止对抗生素耐药的革兰氏阴性菌的出现和传播。
