Infections in febrile neutropenic cancer patients who were undergoing chemotherapy at the Makati Medical Center

ABSTRACT

The immune system of children with malignancies is compromised by chemotherapy and by the cancer itself. In addition, frequent intravenous cannulation, indwelling catheters, malnutrition, prolonged exposure to antibiotics and frequent hospitalizations increase the risk for infection. Neutropenia may lead to an inappropriately low inflammatory response so that fever may be the only manifestation of infection. Management of this complication can vary widely, relating to different geographic patterns of infections and antimicrobial resistance, as well as, issues of treatment availability and cost attainment. The objective of this study was to determine the etiology of infections in febrile neutropenic cancer patients aged 18 years and below who were undergoing chemotherapy at the Makati Medical Center. Inpatient charts of 21 episodes of febrile neutropenia in 19 cancer patients undergoing chemotherapy were reviewed. The primary diseases were mostly acute leukemias (94.7%). Sites of documented infections were the respiratory tract (26.1%), skin and soft tissues (21.7%) oral cavity, ear and sinuses (19.6%), gastrointestinal tract (17.4%), bloodstream (8.7%) and the genitourinary tract (6.5%). Cultures from different sites of infection yielded Escherichia coli (36.4%) and Staphylococcus species (27.3%) to be the most common isolates. The overall mortality was 4.8%. Although broad spectrum antibiotics were used as empiric therapy, the number of isolates obtained was too few to allow a standard recommendation on an appropriate antibiotic regimen.