Author/Authors :
Cömert, M Ege Üniversitesi - Tıp Fakültesi - Hematoloji Bilim Dalı, Turkey , Aydoğdu, İ Celal Bayar Üniversitesi - Tıp Fakültesi - Hematoloji Bilim Dalı, Turkey , Yetkin, F İnönü Üniversitesi - Tıp Fakültesi - Enfeksiyon Hastalıkları Anabilim Dalı, Turkey , Kaya, E İnönü Üniversitesi - Tıp Fakültesi - Hematoloji Bilim Dalı, Turkey , Erkurt, M A İnönü Üniversitesi - Tıp Fakültesi - Hematoloji Bilim Dalı, Turkey , Kuku, İ İnönü Üniversitesi - Tıp Fakültesi - Hematoloji Bilim Dalı, Turkey
Abstract :
Aim: The most important cause of mortality in febrile neutropenic episodes (FNEs) which mature after chemotherapy is infections. Fever in neutropenic patients must be accepted as an infection and broad-spectrum empric antibiotherapy must be started immediately as a standard approach. The infection categories, isolated pathogen microorganisms, mortality ratios and antibiotherapy regimens in 236 FNEs which matured after chemotherapy have been examined retrospectively. Our goal was identification of infectious agents and to determine our treatment protocol.Materials and Methods: Our study includes 87 patients who were treated because of acute myeloid leukemia (AML) at Inonu University Turgut Özal Medicine Center Adult Hematology Clinic between 2002 and 2010. 236 FNEs were examined retrospectively. Infections of patients who met FNE criterias were categorized as microbiologic defined infection (MDI), clinical defined infection (CDI) and fever of unknown origin (FUO). Physical examination and microbiological culture results were obtained from the records.Results: Fifty-three patients were male and 34 female. The mean age was 52.44 years. Fever was evaluated in 30.9% MDI, 40.3% CDI and 28.8% FUO categories. In FNEs, 19.9% efficient pathogen microorganisms were isolated from blood cultures. 51.1% of pathogens which were isolated from blood cultures were gram-positive, 40.4% were gram-negative bacteries and 8.5% were fungus. Pneumonia was detected 47.4% in 95 CDI episodes. The mean neutropenia duration was 13.33 days in all episodes, 16.69 in MDI, 13.09 in CDI and 10.04 days in FUO.Conclusion: If medical centers follow their infection agents closely and modify their empiric antibiotic treatment policies they can supply a useful additive for a better FEN management process.
