Affiliation:
1. Infectious Diseases Department Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Mexico City Mexico
2. Internal Medicine Department Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Mexico City Mexico
3. Clinical Microbiology Laboratory Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Mexico City Mexico
Abstract
ABSTRACTBackgroundFew studies regarding infectious causes of febrile neutropenia (FN) in Mexico are available.AimsWe aimed to describe clinical and microbiological characteristics of FN episodes during induction chemotherapy in adults with acute leukemia.Methods and ResultsThis retrospective cohort from a Mexican tertiary care center included adults with newly diagnosed acute leukemia between January 2014, and December 2018. Clinical and microbiological characteristics were summarized using descriptive statistics. Univariate analyses for associations between clinical characteristics and FN and/or death were made; logistic regression analysis was performed to assess relationships with FN. Kaplan–Meier survival estimates were modeled for antimicrobial prophylaxis and FN. Ninety‐five patients were included. Median age was 28 (IQR 20–43), 49 (52%) were males, and 74 (78%) developed FN (74/95). Among these, 98% had an identified source of infection (73/74) and 65% had >1. Common infections were urinary tract infection (24%), bacterial sinusitis (20%), and bacterial pneumonia (19%). Gram‐negatives were the most frequently isolated microorganisms (69%), followed by Gram‐positives (21%), and fungi (9%). Antimicrobial prophylaxis was inversely associated with FN (aOR = 0.07, CI 0.008–0.060, p = 0.02). Invasive fungal diseases were associated with 30‐day mortality (aOR = 9.46, 95% CI 1.66–54.05).ConclusionInfections caused 98% of the FN episodes. Gram‐negative bacteria are the most common pathogens.