Nosocomial bacteremia in leukopenic patients with leukemia in Baghdad teaching hospital

The incidence of nosocomial bacteremia continues to increase despite antimicrobial therapy and supportive care; it remains a major cause of death in hospitalized patients who are undergoing chemotherapy. The prolonged survival of leukemia patients who have disturbance in their innate immune system increased the factors of risk. This study was conducted to assess the epidemiological features of Bacteremia in adult patients with leukemia and the species distribution and antimicrobial susceptibilities of causative pathogens. In addition, nosocomial bacteremia was compared to community acquired bacteremia. A total of [84] adult leukemic patients more than 15 years old, males and females, feverish or with hypothermia and leukopenic. Bacteremic cases were obtained by culturing blood samples aerobically and anaerobically. The identification of blood isolates and susceptibility testing were performed by the routine methods in use at the affiliated laboratories. It has been found that 15 out of 28 [53.57%] patients with bacteremia acquired the infection during hospitalization, while the 13 [46.42%] patients acquired the infection out side the hospital. Table [1]. High incidence rate of nosocomial infection [hospital acquired infections] in leukopenic leukemic patients with bacteremia

IL-1 alpha and il-8levels during gram-negative and gram-positive bacteremia in leukopenia leukemic patients

A quantitative relationships between circulating leukocytes and infection was established in patients with leukemia, in particular, the probability of being infected is proportional to the severity and duration of leukopenia [1]. Infection with gram- negative as well as gram-positive microorganisms may lead to septic shock and death [2, 3]. The major functional activities of cytokines are concerned with the regulation of the development and behavior of the immune effector cells. IL-1 is one of proximal cytokines. IL-1 act to stimulate the release of distal cytokines, such as IL-6 and IL-8, IL-8 is most closely related to the severity of the physiological response to infection and systemic inflammation. This study was conducted to detect the levels of IL-1 and IL-8 during Gram negative and Gram positive bacteremia. That could be useful in determining an appropriate choice for antimicrobial drug depending on the antimicrobial susceptibility pattern. IL-1 alpha and IL-8 was studied in [28] adult leukopenic patient with bacteremia, males and females, more than 15 years old. The study was including [20] healthy control. The bacteremic cases were obtained by culturing blood samples aerobically and anaerobically. The isolates were identified on the basis of their morphological, cultural and biochemical characteristics. Interleukin-1 alpha and interleukin-8 cocentration were measured by using a commercially available enzyme-linked immunosorbent assay [ELISA]. Statistical analysis show no significant difference in IL-1 alpha levels between Gram-negative and Grampositive bacteremia in leukopenic leukemia patients [P=0.803]. While statistical analysis show significant difference between patient with Gram-negative and Gram-positive bacteremia in leukopenic leukemia patients [P=0.037]. In leukopenic leukemia patients with bacteremia we may could determining an appropriate choice for treatment depending on IL-8 levels in the circulation of those patients and the antimicrobial susceptibility pattern

L-1 alpha and IL-8 levels in leukopenic leukemic patients with bacteremia

lnterleukin-1 alpha and Interleukin-8 are an inflammatory cytokines. They are a heterogeneous group of humeral mediators of the inflammatory response. In leukemic patient's leukopenia developed as a result of cytotoxic chemotherapy and/or disease itself Therefore, those patients were suffering from low number of leukocytes in addition to defects in the function of these cells. Normally leukocytes are the main source of cytokines production. IL-1 alpha and IL-8 were studied in [84] adult patients, males and females and more than 15 years old. The leukemic patients were suffering from leukopenia and bacteremia. The study including [20] healthy. Interleukin-la and interleukin-8 concentrations were measured by using a commercially available enzyme-linked irnmunosorbent assay [ELISA]. Statistical analysis shows significant increase in the levels of IL-1 alpha and IL-8 between leukopenic leukemic patients with bacteremia and healthy control group. Leukopenic leukemia patients strikingly show distinct increases in plasma IL-1 alpha and IL-8 levels during bacteremia