High infection rates in febrile neutropenia with bacterial and viral effects

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Below is a summary of “Current microbiologic testing approaches and documented infections at the onset of febrile neutropenia in patients with hematologic malignancies,” published in the October 2024 issue infectious disease by Mariana et al.

Researchers conducted a retrospective study to identify an infectious etiology in febrile neutropenia (FN). They examined different microbiological approaches and the impact on the diagnosis of infections in people with hematological malignancies and FN.

They analyzed microbiological testing strategies used between January 2020 and July 2022 at the Barcelona Hospital Clinic to diagnose infections in patients with FN.

Results showed that 4,520 microbiological tests were ordered in 462 FN episodes, with a test positivity rate of 10% and microbial evidence of infection in 200 episodes (43.3%). Blood cultures (40.4%), blood tests without culture (21.2%), and respiratory samples (16.2%) were most commonly ordered. Blood cultures had the highest positivity rate (16.9%), while nonculture tests had the lowest (3.3%). Bacterial infections were detected in 149 episodes (32.3%) and viral infections, particularly respiratory viruses, occurred in 66 episodes (14.3%). The 60-day mortality rate was 9.1%, with a higher risk (15%) associated with documented infections.

The researchers concluded that the study revealed a high rate of microbiologically documented infections at the onset of FN, highlighting the prevalence of bacterial and viral infections, particularly respiratory viruses, and the need for optimized treatment of FN in respiratory viral infections and the importance cost-effective diagnostics underlines management.

Source: sciencedirect.com/science/article/pii/S1201971224002546