Title:Study of Common Bacterial and Fungal Pathogens in Children with Hematological Malignancies during Febrile Neutropenia: Single Center Egyptian Study
Volume: 16
Issue: 1
Author(s): Adel A. Hagag, Samir M. Hassan, Mohamed A. Elgamasy and Ibtesam K. Afifi
Affiliation:
Keywords:
Hematological Malignancies, Febrile Neutropenia, Bacterial and Fungal Pathogens.
Abstract: Background: Infection ‘is a common complication in children with hematological
malignancies’ during febrile neutropenia.
‘Objective: The aim of this study was to’ evaluate common bacterial and fungal pathogens
in children with hematological malignancies during febrile neutropenia in single center
Egyptian study.
‘Patients and Methods: This study was carried out on 90’ children with hematological malignancies during
febrile neutropenia including 54 with ALL, 27 with AML and 9 with NHL with their ages ranging from 2.5-
13 years and mean age value of 5.5 ± 3.5. Complete blood count, BM aspiration, and blood and throat cultures
were done for all patients.
Results: Positive bacterial growth was found in 54 cultures (30%) including 42 blood cultures and 12 throat
cultures with significantly higher Gram negative bacterial growth. Staphylococcus aurous and Pseudomonas
aeruginosa were the most common Gram positive and negative organisms respectively. Cefepime was the
most effective antibiotic against isolated bacterial growth where 80% of Gram negative bacterial growth was
sensitive to it, 20% showed intermediate response and no Gram negative Cefepime resistance was recorded.
On the other hand, 62.5% of Gram positive organisms was sensitive to it, 25% showed intermediate response
and Gram positive Cefepime resistance was found in 12.5%. Ampicillin sulbactam ‘was the most effective antibiotic
against Gram positive’ organisms with 100% sensitivity. Positive fungal growth was found in 36 cultures
(20%) including 30 throat cultures and 6 blood cultures and all fungal isolates were candida. Amphotericin
was active against 100% of fungal isolates, while resistance to Fluconazole and Voriconazole was
found in 25% and 33.33% respectively.
Conclusions: ‘Gram negative is still more common than gram positive’ infections and fungal infection is also
a common cause of fever in patients with hematological malignancies during neutropenia and must be taken
in consideration in every case of febrile neutropenia.
