Microbial Infection with Their Antibiotic Sensitivity Pattern in Febrile Neutropenic Patients Treated in Haematology and BMT Unit in DMCH

Abstract

Background: Because of great concerns about mortality and morbidity due to infection in febrile neutropenic patients, the appropriate empirical antibiotic should be started immediately. Although there are established guidelines for the use of empirical therapy in febrile neutropenia, local microbiological pattern and antibiotic susceptibility should be considered for better outcome. There is paucity of data regarding the organism isolated and sensitivity in febrile neutropenic patients in Dhaka Medical College Hospital (DMCH). Objectives: The current study aimed to find out causative organisms for febrile neutropenia and to observe their antimicrobial sensitivity pattern. Materials and method:  This was a prospective observational study carried out in department of haematology and BMT of Dhaka Medical college hospital during the period of October, 2014 to July, 2015. Total 104 patients experienced febrile neutropenia and both febrile blood and urine samples were collected and sent for culture. Results: Out of 104 patients male were 65 and female were 39 (M:F ratio 1.6:1) with a mean age of patients were 31.3 (±15.43) years. Majority (86.5%) of febrile neutropenic patients were post-chemotherapy of acute leukaemia. Out of 104 case 29 were positive growth in both blood and urine samples. Out of 25 blood culture positive patients’ organisms isolated were predominantly gram negative (78.6%) whereas 21.4% were gram negative.  However, in urine culture equal number of organisms (4 vs 4) from both gram positive and gram negative were isolated. Gram negative microorganisms were resistance to antibiotic such as amoxicillin, ceftazidime, ceftriaxone, cefixime, cotrimoxazole and gentamicin and sensitive to antibiotic like meropenem, amikacin, ciprofloxacin and colistin. Gram positive microorganisms were almost resistance to azithromycin, cefixime, ciprofloxacin, cotrimoxazole, gentamicin and moxifloxacin but were sensitive to chloramphenicol, clindamycin and linezolid. Conclusions: Gram negative organisms were the predominant organisms in febrile neutropenic patients at our institute. They are resistant to a good number of commonly used antibiotics and sensitive to only a few antibiotics.