Caracterización clínica y microbiológica de pacientes oncológicos con neutropenia febril en el Hospital del Niño Dr. Francisco De Icaza Bustamante, 2021- 2023.

Abstract

Background: febrile neutropenia in cancer patients, defined as the absolute neutrophil count (ANC) below 500 cells/mm3, accompanied by fever higher than 38.3 °C, constitutes a frequent complication of infectious etiology, which requires immediate intervention. . to minimize its high morbidity and mortality. Objective: to describe the clinical and microbiological characteristics of oncological patients with febrile neutropenia, at the Dr. Francisco De Icaza Bustamante children's hospital, in the period from 2021 to 2023. Materials and methods: a descriptive, retrospective study was carried out at the hospital. from the child Dr. Francisco De Icaza Bustamante, period 2021-2023, about the clinical and microbiological characteristics of oncological patients with febrile neutropenia; This study was carried out through a non-experimental and cross-sectional design with a sample of 135 patients who met the inclusion criteria. Results: the age group of the majority of patients (40.0%) is between 1 and 4 years. The male sex constitutes 58.5% while the female sex constitutes 41.5%. The majority of patients come from the city of Guayaquil (40.0%), followed by different sectors of the province of Guayas (31.9%). The most common symptomatology reported was fever (65.9%). Acute lymphoblastic leukemia (ALL) is the most common diagnosis, representing 67.4% of cases; Regarding complications, the large percentage of patients (78.5%) did not present any reported complications; However, sepsis was more common, affecting 7.4%. The frequently isolated microorganism was Candida spp. with 14.1% of cases, followed by Klebsiella pneumoniae and Staphylococcus aureus in 12.6% and 8.9% respectively. 83.7% of patients received antibiotics as initial treatment; 4.4% received antifungals, while 11.9% received a combination of both. Severe neutropenia is more common in patients with bacteremia, representing 72.6%, and respiratory infections constitute 8.9%. Moderate neutropenia occurs in 33.3% of patients with bacteremia, while mild neutropenia occurs in 36.3% of cases with various infectious foci. The findings provide a comprehensive understanding of the clinical and microbiological characteristics of oncology patients with febrile neutropenia at the Dr. Francisco De Icaza Bustamante children's hospital, providing a solid foundation to improve the care and management of this vulnerable population.