Abstract 565P
Background
Neutropenia is one of the most frequent complications of cytotoxic chemotherapy induced myelosuppression. It may last several weeks & risk of mortality from infection is increased. It impacts cancer treatment in several negative ways, including increased mortality from infection, treatment cost, more frequent hospitalisations, reduction in dose intensity of chemotherapy and treatment discontinuation.
Methods
This is a single centre observational study of 220 neutropenic cancer patients from March - May 2024. Baseline characteristics noted and appropriate culture samples sent based on patients symptoms, before starting broad spectrum empirical antibiotics. Antibiotics were later modified according to culture & sensitivity reports, if an organism was isolated and others continued on empirical regimen and antibiotics escalated based on clinical condition. The 30-day mortality was measured.
Results
Culture positivity rate among neutropenic patients was 30.9%. The 30-day mortality among Neutropenic patients was 18.1% The most common organism isolated was Klebsiella pneumoniae [MDRO] 26.4% followed by Escherichia coli (CRE) 19.1% The 30-day mortality amongst culture positive neutropenic patients was 13.2% The most common cancer among neutropenic patients that expired was acute lymphoblastic leukaemia (relapsed/ high-risk cases) post HR block, followed by AML post 3+7 chemotherapy Among culture positives, prevalence of MDR (multi drug resistant) bacteria was41.1% Percentage of patients who expired due to MDR infection Vs sensitive isolate among culture positive was 77.7% & 22.2% Patients with MDR infection were more likely to die compared to those infected with a sensitive isolate. The result was statistically significant p < 0.05.
Conclusions
Patients with an MDR infection had worse outcomes as compared to those with a sensitive isolate. Antibiotic prophylaxis has been a complimentary strategy toward reduction of infections but has also led to the emergence of multidrug resistant organisms . An appropriate culture & sensitivity report helps in antibiotic stewardship & better outcomes while also preventing the development of resistant organisms.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
H. Parupalli.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.