Entrar/Registro  
HOME SPANISH
 
Revista de Hematología
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Revista de Hematología >Year 2013, Issue 3


González-Leal XJ, Molina-Gamboa J, Bolaños-Meade J, Villela L
Microbial isolates in patients with febrile neutropenia. Are the international guidelines appropriate in México?
Rev Hematol Mex 2013; 14 (3)

Language: Español
References: 18
Page: 113-119
PDF: 303.64 Kb.


Full text




ABSTRACT

Background: febrile-neutropenia (FN) episodes could add morbidity/ mortality to hematological patients treated to chemotherapy. Indeed, it is necessary to get a proper approach for these patients. For this reason, we described a cohort of NF in our institution analyzing resistance patterns and prognostic factors of mortality.
Methods: Cases were obtained from Hospital San José Tec de Monterrey from January 2010 to December 2011. We described clinical features, MASCC scale and the isolation of germs in blood cultures and analyzed predictive variables associated to positive blood cultures and mortality.
Results: 40 cases of FN were reported. 38% had positive blood cultures, E. Coli was the most frequent (86%). E. Coli showed 100% resistance to quinolones and 38% to extended spectrum beta lactamase (ESBL) production. There was association among high risk score in the MASCC scale, profound neutropenia and risk of having positive blood cultures (p ≤ 0.05). There was association between the admission to the intensive care unit and increased in mortality (p ≤ 0.01).
Conclusions: We think it is not appropriate to use the international guidelines recommendations for empiric therapy in our institution, due to the high prevalence of quinolones resistance and ESBL production. Thus, every recommendation should be emitted by Institution depending of local resistance patterns.


Key words: Febrile-neutropenia, bacteriemia, MASCC scale, clinical guides, mortality.


REFERENCIAS

  1. National Comprehensive Cancer Network (NCCN) guidelines. Prevention and treatment of cancer related infections. Disponible en: www.nccn.org 2012 (Accesado 3 oct 2012)

  2. Klastersky J. Management of fever in neutropenic patients with different risks of complications. Clin Infect Dis 2004;39:S32-37.

  3. Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, James II, Craig AM et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis 2011;52: e56-e93.

  4. Gaytán-Martínez J, Mateos-García E, Sánchez-Cortés E, González-Llaven J, Casanova-Cardiel L, Fuentes-Allen JL. Microbiological findings in febrile neutropenia. Arch Med Res 2000;31:388-392.

  5. Klastersky J, Ameye L, Maertens J, Georgala A, Muanza F, Aoun M, et al. Bacteraemia in febrile neutropenic cancer patients. Int J Antimicrob Agents 2007:30:S51-S59.

  6. Winston DJ, Lazarus HM, Beveridge RA, Hathorn JW, Gucalp R, Ramphal R, et al. Randomized, Double-Blind, Multicenter Trial Comparing Clinafloxacin with Imipenem as Empirical Monotherapy for Febrile Granulocytopenic patients. Clin Infect Dis 2001;32:381-390.

  7. Del Favero A, Menichetti F, Martino P, Bucaneve G, Micozzi A, Gentile G y Gruppo Italiano de Malattie Ematologiche dell’Adulto (GIMEMA) Infection Program. A Multicenter, Double-Blind, Placebo-Controlled Trial Comparing Piperacillin- Tazobactam with and without Amikacin as Empiric Therapy for Febrile Neutropenia. Clin Infect Dis 2001;33:1295-1301.

  8. González-Barca E, Fernández-Sevilla A, Carratalá, J, Grafiena A, Gudiol F. Prospective study of 288 episodes of bacteremia in neutropenic cancer patients in a single institution. Eur J Clin Microbiol 1996;15:291-296.

  9. Ramphal R. Changes in the etiology of bacteremia in febrile neutropenic patients and the susceptibilities of the currently isolated pathogens. Clin Infect Dis 2004;39:S25-31.

  10. Brown, Erwin, Nathwani, Dilip. Antibiotic cycling or rotation: a systematic review of the evidence of efficacy. J Antimicrob Chemother 2005;55:6-9.

  11. Cordonnier C, Buzyn A, Leverger G, Herbrecht R, Hunault M, Leclercq R, et al. Epidemiology and Risk Factors for Gram- Positive Coccal Infections in Neutropenia: Toward a More Targeted Antibiotic Strategy. Clin Infect Dis 2003;36:149-158.






>Journals >Revista de Hematología >Year 2013, Issue 3
 

· Journal Index 
· Links 






       
Copyright 2019