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>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


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.


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

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