Prevalence of bacterial resistance in critically ill patients with neutropenic fever at National Cancer Institute of Egypt

Abstract

Background
Febrile neutropenia (FN) is a life-threatening complication in cancer patients that include serious infections with different microorganisms. Unfortunately, resistant pathogens rapidly progressed over the last two decades with a direct impact on survival and health of FN patients. we tried to study the prevalence of bacterial resistance at different infection sites in these patients.


Patients and methods
This was a retrospective observational cohort study to assess prevalence of bacterial resistance in 1257 patients with neutropenic fever and positive cultures from different sites of infections, admitted to the Medical Oncology intensive care unit (ICU) at national cancer institute (NCI), Egypt, from May 2021 to May 2023.


Results
One thousand two hundred fifty-seven patients were included, total number of detected organisms was 2221, 1895 were bacterial organisms, most of these isolates were extensively drug-resistant (XDR) gram-negative (57.9%) followed by methicillin resistant coagulase negative staphylococci MR_CONS (18.6%) and multidrug resistant (MDR) gram-negative (14.9%), with emergence of pan-drug resistant (PDR) gram-negative bacteria (2.4%).


Conclusion
Resistant bacteria are now predominant in patients with neutropenic fever especially with gram-negative bacteria being commonly XDR with an emergence of PDR organisms.