Febrile neutropenia is a serious complication of chemotherapy. Prompt antibiotic treatment and assessment including blood and urine cultures is indicated as per Australian guidelines1. Positivity of blood cultures isolation as per international literature is low as 10 to 25%2.
We collected information regarding completion of mandatory investigations and microbiological results in order to identify the predominant organisms in patients presenting with febrile neutropenia to Goulburn Valley Health.
Methods and materials
We performed a retrospective review of medical records of patients who presented with febrile neutropenia at our institution between January 1st 2016 and 31st January 2017. We collected information regarding patient characteristics, the number of patients who had blood and urine cultures collected, microbiological results of cultures and antibiotic sensitivity.
A total of 74 patients with febrile neutropenia presented during the 13 months’ period. 4 patients (5.4%), and 10 patients (13.5%) did not have blood/urine cultures collected respectively. Blood cultures were positive in 9 patients (12.8%). Gram positive cocci was the predominant organism isolated from blood cultures, 6 patients (66%). Urine cultures were positive in 5 patients (7.8%). The predominant organism isolated from urine cultures was Escherichia coli in 3 patients (60%).
Our study results are in keeping with international literature revealing a low likelihood of identifying infective organism in blood cultures of patients presenting with febrile neutropenia. Gram positive cocci was the most common isolated organism in keeping with most recent literature. This data is important as identified the local flora for treatment guidance in our regional Victorian hospital.