NEUTROPENIC FEVER IN ONCOLOGICAL PATIENTS: CHARACTERISTICS OF THE TREATMENT AND THE MAIN BIOCHEMICAL MARKERS (Atena Editora) (original) (raw)
Related papers
2021
Cl inical and Biochemical diagnosis of patients with febrile neutropenia attended Babylon Cancer Treatment center Diagnóstico clínico y bioquímico de pacientes con neutropenia febril atendidos en el centro de tratamiento del cáncer de Babylon Background: Febrile neutropenia define as an oral fever of more than 38.3°C or 38.0°C sustained for more than one hour, with absolute neutrophil count (ANC) should be <500/μL. FN associated with high rate of disease indisposition, mortality, affect chemotherapy price and doses, and leading to chemotherapy course interruptions, as well as affects the chemotherapy potency. Aim of study: This study was aimed to estimate the patients that have cancer and newly diagnosed with febrile neutropenia Patients and methods: A retrospective study that included one hundred and fifty patients already diagnosed with cancer who attended the outpatient clinic of Babylon Cancer Treatment Center, from 1 st of January 2020 to 1 st of January 2021. Results: From a total of 150 patients, age of patients ranged from 20-85 years, with mean age of 62.3±10.17 years, 63(42%) were males and 87(58%) were females. Breast cancer form 40%, as the most common solid cancers presented with febrile neutropenia, while head and neck cancer form 2%. We found 20% blood culture positive, and E. coli most bacterial isolated (40%), while 8.66% was positive urine culture and E. coli was form 84.6% also most commonly urine bacterial isolated, and only 2.66% sputum culture was positive and S. pneumonia is most common bacterial isolated (50%). 73.34% of patients presented with fever without localizing symptoms, while 12.66% of patients presented with respiratory system related symptoms. We found day 8 th after last cycle of chemotherapy was the most day of starting fever (28.66%). Conclusion: FN is a leading cause of cancer related death, early management is required to decrease rate of mortality.
Febrile neutropaenia in cancer patients
The West Indian medical journal, 2010
BACKGROUNDS Febrile neutropaenia is a common complication of chemotherapy in cancer patients. Empirical antibiotic regimes are based on the epidemiological characteristics of bacterial isolates globally and locally. METHOD This study retrospectively reviewed all cases of febrile neutropaenia in patients with confirmed cancer admitted at the University Hospital of the West Indies in the four-year period between, January 1, 2003 and December 31, 2006 and who received chemotherapy. Cases were identified from blood culture records and hospital charts which were reviewed to determine the aetiological agents causing bacteraemia, their antimicrobial susceptibilities and clinicalfeatures. These cases were compared with non-neutropaenic cancer patients admitted with fever. RESULTS A total of 197 febrile episodes in cancer patients were reviewed. Thirty-seven per cent had febrile neutropaenia while 62% were non-neutropaenic. Acute myeloid leukaemia was the most common haematological malignanc...
2013
Objective: Febrile neutropenic episodes (FNEs) are among the major causes of mortality in patients with hematological malignancies. Secondary infections develop either during the empirical antibiotic therapy or 1 week after cessation of therapy for a FNE. The aim of this study was to investigate the risk factors associated with secondary infections in febrile neutropenic patients. Materials and Methods: We retrospectively analyzed 750 FNEs in 473 patients between January 2000 and December 2006. Results: Secondary infections were diagnosed in 152 (20%) of 750 FNEs. The median time to develop secondary infection was 10 days (range: 2-34 days). The duration of neutropenia over 10 days significantly increased the risk of secondary infections (p<0.001). The proportion of patients with microbiologically documented infections was found to be higher in primary infections (271/750, 36%) compared to secondary infections (43/152, 28%) (p=0.038). Age; sex; underlying disease; antibacterial, antifungal, or antiviral prophylaxis; blood transfusion or bone marrow transplantation; central venous catheter; and severity of neutropenia did not differ significantly between primary and secondary infections (p>0.05). While fever of unknown origin (p=0.005) and catheter-related bacteremia (p<0.001) were less frequently observed in secondary infections, the frequency of microbiologically (p=0.003) and clinically (p<0.001) documented infections, fungal pneumonias (p<0.001), infections related to gram-positive bacteria (p=0.04) and fungi (p<0.001), and 30-day mortality rate (p<0.001) were significantly higher in cases of secondary infections (p<0.001). Conclusion: Secondary infections should be regarded as life-threatening complications of febrile neutropenia. Secondary infections represent a more severe and mortal complication and cannot be regarded just as another FNE.
2015
From year to year, it is important to get an overview of the occurrence of causative agents in febrile neutropenic patients to deter-mine the empiric treatment. Thus our aims were to evaluate a four-year period regarding the prevalence of bloodstream infections and the most important causative agents. During this period, 1,361 patients were treated in our hematology ward because of various hematological disorders. 812 febrile episodes were recorded in 469 patients. At that time, 3,714 blood culture (BC) bottles were sent for microbiological investigations, 759 of them gave positive signal. From the majority of positive blood culture bottles (67.1%), Gram-positive bacteria, mainly coagulase-negative staphylococci (CNS), were grown. Gram-negative bacteria were isolated from 32.9 % of the positive blood culture bottles, in these cases the leading pathogen was Escherichia coli. The high prevalence of CNS was attributed to mainly contamination, while lower positivity rate for Gram-negati...
Indian Journal of Medical and Paediatric Oncology, 2013
Background: The aim of this study was to study clinical profile with bacterial spectrum and susceptibility patterns of pathogens in culture positive febrile neutropenic (FN) patients of hematological malignancies. Materials and Methods: We retrospectively reviewed the medical records of 23 hematological malignancy patients admitted with chemotherapy induced febrile neutropenia with culture positive results, at our institute between June 2011 and December 2011. Results: A total of 23 patients were studied 12 males and 11 females, with a median age of 35 years. Most common diagnosis was acute leukemia (78%) with the majority of patients developing febrile neutropenia during the induction phase of treatment. Most common presenting symptoms were fever, cough, dyspnea, and diarrhea. Primary site of infection was not found in 47% of patients while the rest had lung, gastro-intestinal and skin/soft-tissue infection. Overall 23 organisms were isolated during the study period, from blood (56...
Management of the Cancer Patient With Infection and Neutropenia
Seminars in Oncology, 2011
Infections are major causes of morbidity and mortality in cancer. The intensity and duration of immunosuppressive chemotherapy determine the risk. Cancer may be associated with immune defects, in particular hematologic malignancies. Predisposing factors include tumor site, intravenous devices, neutropenia due to underlying disease, mucosal lesions, corticosteroids, monoclonal antibodies, splenic dysfunction, and treatment with chemotherapy or radiation therapy. Bacteremia is documented in approximately 25% of people with febrile neutropenia. The drug choice for empiric therapy is influenced by factors related either to the patient or to the institution. Guidelines and general statements should always take local epidemiology into consideration. The therapeutic hematopoietic growth factors should be reserved for patients with fever and neutropenia and those at high risk for infection-associated complications or poor clinical outcomes. The Multinational Association of Supportive Care in Cancer (MASCC) has developed a Risk Index that predicts the risk of medical complications and outcome. Semin Oncol 38:424-430.
Evaluation of Risk Factors for Mortality in Febrile Neutropenia
The Journal of Infection in Developing Countries, 2020
Introduction: We aimed to evaluate the epidemiology of infections and factors associated with mortality in patients with febrile neutropenia (FEN). Methodology: The adult patients, who developed FEN after chemotherapy due to a hematologic malignancy or a solid tumor in a training and research hospital were evaluated, retrospectively. The demographic data of the patients, underlying malignancy, administered antimicrobial therapy, microbiological findings, and other risk factors associated with mortality were evaluated. Results: A total of 135 FEN episodes of 115 patients, who comprised of 72 (63%) patients with 89 FEN episodes due to hematologic malignancies (hemato-group) and 43 (37%) patients with 46 FEN episodes due to solid organ cancers (onco-group), were evaluated in the study. The median age was 47 years (range: 17-75 years) and 66 (57%) patients were male. A total of 12 patients (8.8%) died during 135 episodes of FEN including nine cases from hemato-group and three cases from onco-group. Those factors including a presence of pneumonia, advanced age, persistent fever despite an antimicrobial treatment, and need for mechanical ventilation in intensive care unit (ICU) with were determined as risk factors associated with mortality. Conclusions: Morbidity and mortality are more common in patients with hematological malignancies compared to patients with solid organ cancers due to prolonged neutropenia. In case of persistent fever, an invasive fungal infection (IFI) should be kept in mind in patients with hematologic malignancies and then antifungal treatment should be initiated. Although a persistent fever is also common in patients with solid tumors, the necessity of antifungal therapy is rare due to the short duration of neutropenia.
Journal of Research in Pharmacy Practice
Objective: Febrile neutropenia (FN) is one of the most serious clinical problems in patients with hematologic malignancies and patients receiving chemotherapy. The present study was implemented to determine precisely how FN is managed in most referral hospitals in Isfahan (Iran) and what are the characteristics of FN patients as well as risk factors associated with FN development. Methods: This study was a cross-sectional study performed over a period of 6 months on patients hospitalized in the Hematology-Oncology Center of Omid Hospital, Isfahan, Iran. The information was collected by filling the designed data abstraction form. Findings: A total of 115 oncology patients were admitted with or encountered to FN. This equates to a cumulative incidence of 1.26% of FN cases per 1000 oncology admissions. The average age was 49.5 ± 18.02 years (range 18-85 years), with 42.6% of patients being female. The most frequently prescribed antibiotic agents were meropenem (91.3%) and vancomycin (47.82%) alone or in combination. Empiric antifungal agents initiated in 20.86% of cases, and we could not find any patients who needed to receive antiviral treatment. From all positive cultures, Gram-positive microorganisms were the most found pathogen. Among them, female sex (42.6%) and lymphopenia (26.5%) were the most noted predictors. Neutropenia (81.7%) was the most reported risk factors for serious complications. Conclusion: Although our center is university-affiliated, there are still several points, and pitfalls must be considered and revised in the management of FN patients. Obtaining and assessing the samples microbiologically and antibiotic therapy accordingly were the most troublesome complications.