Background and objectives: The aim of this study was to determine the drug susceptibility pattern of the pathogens causing bacteraemia and fungemia in patients who have developed febrile neutropenia after chemotherapy.
Materials and methods: A total of 95 patients with suspected or proven malignancy (50 patients) were admitted to the adult haematology ward at Taleghani Hospital in Tehran. Blood samples were inoculated into the bottles of Bact/Alert blood culture system and sent to Payvand's clinical and special laboratory immediately and then incubated at 35 ± 2°C. Culture from positive bottles were plated on appropriate media and incubated at 37°C and 30°C for bacterial and fungal isolation, respectively. A bacterial suspension with turbidity equal to 0.5 McFarland (1.5 × 108 CFU/mL) was prepared and used for the Vitec2 system (biomerioux). Statistical analysis using independent Fisher's exact test was conducted and a p-value of < 0.05 was considered as significant.
Results: Among 50 patients with approved malignancy, Acute Lymphoblastic Leukaemia (ALL) and Acute Myeloid Leukaemia (AML) were the most common underlying diseases. This study showed, 20% (n: 10) of febrile neutropenic episodes established positive blood culture. Of them, 3 were Gram-negative (30%) and 5 were-Gram-positive bacteria (50%) and 2 patients (20%) showed fungemia with Fusarium spp.
Conclusion: It is crucial to know about the likely pathogens and their local antibiotic and antifungal sensitivity patterns. Such local findings will show if any modifications to treatment guidelines are necessary.
Keywords: Blood culture; Cancer; Chemotherapy; Febrile neutropenia; Fungemia.