Background: Although Gram negative as well as Gram positive bacteria participate in febrile episodes of neutropenic patients, in particular recently the ratio of Gram positive bacteria is increasing. The objective of the present work was to investigate the incidence and antibiotic resistance of pathogenic bacterial agents in neutropenic patients.
Methods and results: The presence of bacteria was investigated in 446 neutropenic patients hospitalized at the Haematological Clinic in 1995. Haemocultures (apparatus Bact/Alert 120, cultivation media Organon-Teknika) and urine were examined. The sensitivity for antibiotics was tested by the standard dilution micromethod. In blood most frequently Staphylococcus epidermidis was isolated (45.4%), coagulase-negative strains of Staphylococcus haemolyticus, Staphylococcus hominis and Staphylococcus saprophyticus (14.4%), Acinetobacter calcoaceticus-baumannii (complex 6.3%) and Pseudomonas aeruginosa (6.3%). In urine the following were detected: Staphylococcus epidermidis (36.5%), Enterococcus sp. (14.5%), Escherichia coli (13.1%), Enterococcus faecalis (11.6%) and Enterococcus solitarius (6.5%). In all strains resistance to antibiotics and chemotherapeutic drugs was assessed.
Conclusions: Investigation of the frequency of different bacterial species, along with monitoring of the resistance is an essential prerequisite of initial antibiotic therapy of febrile episodes in neutropenic patients.