Research Article

Evaluation of the Distribution and Antimicrobial Susceptibility of Gram-negative Bacteria Isolated from Blood Cultures in Heamatologic Febrile Neutropenia Attacks


  • Güle Çınar
  • Duygu Öcal
  • Güldane Cengiz Seval
  • İrem Akdemir Kalkan
  • Ezgi Gülten
  • Elif Mukime Sarıcaoğlu
  • Haluk Güriz
  • Sinem Civriz Bozdağ
  • Selami Koçak Toprak
  • Meltem Kurt Yüksel
  • Alpay Azap

Received Date: 15.08.2022 Accepted Date: 23.09.2022 J Ankara Univ Fac Med 2022;75(3):373-378


Bacterial bloodstream infections with resistant pathogens in patients with hematological malignancies are increasing due to the more use of new chemotherapeutic agents and prophylactic antibiotics. In this study, it was aimed to determine the epidemiology and resistance rates of gram-negative bacterial pathogens isolated from blood cultures of febrile neutropenic patients with hematological malignancies in order to help the correct administration of empirical antibiotics and to limit resistance.

Materials and Methods:

Antibiotic susceptibility of gram-negative bacteria, which were grown in the blood cultures of hematological febrile neutropenic patients in a tertiary university hospital between 2019 and 2021 and determined as bloodstream infection, was retrospectively investigated.


Between January 1, 2019 and December 31, 2021, a total of 388 gram-negative isolates, which were isolated from blood cultures and evaluated as bloodstream infection, in the febrile neutropenia attacks of patients with hematological malignancies hospitalized in the hematology service were evaluated, and the most common isolated pathogen was found to be Klebsiella spp. (41.7%). When evaluated in terms of multi-drug resistance, it was determined that Klebsiella spp. was in the first and Acinetobacter spp. was in the second place. When evaluated in terms of piperacillin-tazobactam susceptibility, which we frequently use in the empirical treatment of febrile neutropenic patients, 70.3% of Klebsiella spp., 37.7% of Escherichia coli, 86% of Acinetobacter spp. and 67.5% of Pseudomonas spp. were found to be resistant to piperacillin-tazobactam. Carbapenem resistance was also found to be between 29% and 80%.


It is noteworthy that all gram-negative strains were highly resistant to piperacillin-tazobactam, which is used as empirical treatment of febrile neutropenia attacks, and that carbapenem resistance was found at a substantial rate. Considering these data may contribute to reducing morbidity and mortality while arranging empirical treatment guidelines and antibiotic management programs in febrile neutropenia attacks seen in hematological malignancy patients both in our hospital and in Turkey.

Keywords: Febrile Neutropenia, Hematologic Malignancy, Antimicrobial Sensitivity, Multidrug Resistance

Full Text (Turkish)