COMMON ORGANISM IN BLOOD CULTURE OF NEUTROPENIC PATIENTS

Abstract

Background: Bloodstream infections (BSIs) are a significant complication of neutropenic patients, especially those receiving chemotherapy for malignant disorders. Rapid identification of the etiologic microorganisms is indispensable for the prompt administration of the proper antimicrobial agents and for improving the survival of the patient.

Objective: To determine the most frequent isolated microorganisms from blood cultures in neutropenic patients and to assess the concomitant antimicrobial resistance patterns and the clinical outcomes.

Methods: This prospective observational study was performed at the department of hematology and oncology, Shifa international hospital, Islamabad. Total of 300 patients aged ≥18 years who had febrile neutropenia and had at least 1 positive blood culture were included. Demographic data, clinical features, microbiological results, antimicrobial susceptibility profiles and clinical outcome were entered on a structured proforma. Data were analyzed by using the software SPSS v.31.0.

Results: Among 300 culture-positive neutropenic patients, 57.3% were male and 54.0% were admitted to hematology/oncology wards. Gram-negative organisms predominated (71.7%), followed by gram-positive (17.0%) and fungal isolates (11.3%). The most common pathogens were E. coli (21.7%), Klebsiella pneumoniae (15.3%), and Pseudomonas aeruginosa (9.7%). Multidrug resistance was observed in 37.3% of isolates and extensively drug-resistant organisms in 11.0%. Overall mortality was 17.0%. Patients who died had significantly lower ANC, longer duration of neutropenia, and delayed administration of appropriate antibiotics.

Conclusion: Gram-negative organisms remain the major cause of BSIs in neutropenic patients. Early detection of pathogens and surveillance of antimicrobial resistance patterns are needed to support empirical antibiotic treatment and enhance patient outcomes.