Epidemiology of clinically significant bacteremia in patients with febrile neutropenia presenting to an adult emergency department: a 12-year retrospective analysis from a tertiary care center

Abstract

Background Febrile neutropenia (FN) is a serious complication in cancer patients.  Aim: To describe the epidemiological, clinical, and microbiological characteristics of patients with FN seen at the central emergency department of a university hospital in Buenos Aires between 2011 and 2023. Patients and Methods: Retrospective observational cohort study in patients older than 18 years with an absolute neutrophil count ≤ 500 cells/mm³. The bacteremia rate, antimicrobial resistance pattern, and mortality were analyzed. Clinical data were taken from electronic medical records. Results: The rate of clinically significant bacteremia was 10.5%, predominantly involving Gram-negative bacilli, with Escherichia coli being the most frequent microorganism.  High resistance to quinolones and third-generation cephalosporins was observed, but minimal resistance to carbapenems. The median hospital stay was 8.3 days, and in-hospital mortality reached 31.1%. Discussion: The incidence of bacteremia in our cohort was similar to that reported in national studies. Mortality was high in patients with bacteremia. This study provides local data on the epidemiology in adults with FN. The findings underscore the need for early management and adjustment of empirical treatment according to local microbial resistance.