Causative pathogens among febrile neutropenic cancer patients at the St. Lukes Medical Center.

To identify the causative pathogens among febrile neutropenic patients, the records of 17 cancer patients (6 M, 11 F) with febrile neutropenia admitted between February 1994 to September 1995 were reviewed. Data gathered include age, sex, diagnosis, results of cultures and sensitivities, choice of antibiotic, use of GMCSF or GCSF, and onset and duration of neutropenia after chemotherapy. A total of 20 febrile neutropenic events, defined as the onset of neutropenia with fever which terminates in either resolution of neutropenia or patients death, were included. The diagnosis were breast cancer (4), NHL (3), 2 each for AML, ovarian cancer and NSCLC, and 1 each for testicular cancer, NPCA, endometrial carcinoma and leiomyosarcoma. Eighteen of 60 (30%) cultures taken from blood and other body fluids grew microorganisms. Pseudomonas sp. and E. coli, sensitive to ceftazidine (CFD), amikacin (AMK), imipenem and ciprofloxacin were commonly isolated. CFD and AMK were the most frequent antibiotics used empirically. The mean onset and duration of neutropenia were 10 days (4-16 days) and 4 days (1-15), respectively. GCSF or GMCSF were given at a mean duration of 3.5 days (1-8) in all except 2 events. Five patients died of sepsis. Thus, gram-negative bacteria are the most commonly isolated pathogens. However, the causative organism could be isolated in only 30% of cases. (Author)