Correlation of Absolute Neutrophil Count and Prevalence of Bacteremia in Chemotherapy Induced Neutropenia in a Tertiary Care Centre

Title: Correlation of Absolute Neutrophil Count and Prevalence of Bacteremia in Chemotherapy Induced Neutropenia in a Tertiary Care Centre

Author: Dr Yazhini K, MBBS., MD

DOI: https://dx.doi.org/10.18535/jmscr/v7i6.185

Abstract

Background: Neutropenic complications remain an important dose-limiting toxicity of cancer chemotherapy, associated with considerable morbidity, mortality, and cost. Bloodstream infection (BSI) is the most common complication leading to reduced dosage of chemotherapeutics and longer hospitalization. This study was aimed to determine the prevalence of BSI in neutropenic patients with solid tumours receiving chemotherapy in a tertiary care centre.

Objectives:

To determine the prevalence of bacteremia in neutropenicpatients with solid malignancy receiving chemotherapy.
To correlate the prevalence of bacteremia with the absolute neutrophil count of the patient.

Methods: A cross-sectional study was designed for prevalence of BSI in 150 patients with neutropenia who received chemotherapy for solid malignancies. Two samples of blood collected at one hour interval from each patient were plated onto agar plates and the isolates were identified by standard microbiological techniques and VITEK 2 identification systems.

Result: Among the 150 patients, 30(20%) patients had microbiologically documented blood stream infection. Gram positive cocci contributed to 89%(n=28) and Gram negative bacilli 11%(n=2). Among the Gram positive cocci, Staphylococcus epidermidis was the predominant isolate comprising 89.29% (n=25).The patients with documented BSI had their Absolute neutrophil count level between 560 x109/L and 730 x109/L.

Conclusion: The prevalence of bloodstream infection in patients with chemotherapy induced neutropenia was 20% and Staphylococcus epidermidis was the predominant isolate (83.3%). Hence, the Absolute neutrophil count below 1000 ×109/L in patients receiving chemotherapy should alert the treating clinician about the possible risk of bloodstream infection to reduce hospitalization and to prevent the morbidity and mortatlity associated with neutropenia.

Keywords: Neutropenia, Chemotherapy, Bacteremia, Bloodstream infection, Chemotherapy induced neutropenia, Staphylococcus epidermidis.

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Corresponding Author

Dr Yazhini K, MBBS., MD

Assistant Professor & Consultant Microbiolgist, Meenakshi Ammal Dental College & Meenakshi General Hospital

Address: No.12, Padmavathynagar, 13^th cross street, Thirumullaivoyal, Chennai – 600062, India