Clinical and microbiological profile of febrile neutropenia in solid tumors and hematological malignancies at a tertiary cancer care center in South India

Indian J Cancer. 2014 Oct-Dec;51(4):464-8. doi: 10.4103/0019-509X.175330.

Abstract

Background: Febrile neutropenia (FN) is a common but serious complication of chemotherapy in patients with solid tumors (ST) and hematological malignancies (HM). The epidemiology of FN keeps changing.

Objective: The objective was to study the epidemiology of FN in adult patients with ST and HM at Kidwai Memorial Institute of Oncology, Bangalore - A tertiary cancer care center.

Materials and methods: Data of all episodes of FN that occurred during the period July 2011 to December 2011 were collected prospectively and analyzed.

Results: A total of 75 episodes of FN was observed during study period involving 55 patients. Febrile neutropenic episodes were more frequent in HM than in ST (57% vs. 43%). The rate of bloodstream infection was 14.7%. Gram-negative organisms were the predominant isolates (56.25%). Overall mortality rate was 13.3%. Presence of medical co-morbidity and positive culture predicted high mortality. Mortality rate did not differ significantly between HM and ST (14% vs. 12.5%; P = 1.0). Gram-positive bacteremia was associated with greater mortality than Gram-negative bacteremia (P = 0.02).

Conclusion: Empiric antibiotic treatment for FN should be tailored to the locally prevalent pathogens and their susceptibility patterns.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Antineoplastic Agents / adverse effects
  • Bacteremia / microbiology*
  • Bacteremia / mortality
  • Chemotherapy-Induced Febrile Neutropenia / complications
  • Chemotherapy-Induced Febrile Neutropenia / epidemiology*
  • Female
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Positive Bacteria / isolation & purification
  • Hematologic Neoplasms / drug therapy*
  • Hematologic Neoplasms / mortality
  • Humans
  • India / epidemiology
  • Male
  • Neoplasms / drug therapy*
  • Neoplasms / mortality
  • Prospective Studies
  • Tertiary Care Centers

Substances

  • Antineoplastic Agents