Abstract

Objective: We evaluated the type of infections, spectrum of isolated pathogens and the profile of antimicrobial resistance in patients with hematologic malignancy admitted to Adult Hematology Clinic of Antalya Education and Research Hospital.

Methods: Infectious episodes developing in patients with hematologic malignancy and consulted by Infectious Diseases and Clinical Microbiology specialists between January 2011 and December 2012 were retrospectively reviewed.

Results: A total of 57 infectious episodes were documented in 35 patients with hematologic malignancy. The average age of the patients was 48.64±18.45 (19-78) years and 71.4% of the patients were male. Acute leukemia was the most common primary disease (62.9%). Microbiologically and clinically documented infections were 84.2% and 15.8%, respectively. The most common infectious episodes were bacteremia (43.9%), pneumonia (12.3%) and herpes zoster (10.5%). Gram-negative bacteria were the most frequently isolated pathogens (52.9%). Among 30 episodes of bloodstream infections, Gram-positive bacteria accounted for 14 (46.7%) episodes. Extended spectrum β-lactamase was detected in 35.7% of Escherichia coli isolates. 28.6% of E. coli were resistant to fluoroquinolones. While all of Staphylococcus aureus isolates were susceptible to methicillin, isolates of coagulase-negative staphylococci were resistant to methicillin. Mortality attributed to infection was 8.6%.

Conclusions: Proper empirical antimicrobial therapy based on the susceptibility pattern of potential bacterial isolates is a life-saving approach. Bacterial epidemiologic data of hematological patients should be followed with a continuous and active surveillance system, while taking into account the changing flora and regional resistance pattern to antibiotics over the years.