Clinical study of carbapenem sensitive and resistant Gram-negative bacteremia in neutropenic and nonneutropenic patients: The first series from India

• Published in: Indian journal of cancer Vol. 51; no. 4; p. 453
• Main Authors: Ghafur, A K, Vidyalakshmi, P R, Kannaian, P, Balasubramaniam, R
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01.10.2014; Medknow Publications & Media Pvt. Ltd
• Subjects: Acinetobacter Infections - drug therapy; Adult; Bacteremia; Bacteremia - drug therapy; Bacteremia - microbiology; Bacteremia - mortality; Carbapenems; Carbapenems - pharmacology; Carbapenems - therapeutic use; Development and progression; Dosage and administration; Drug Resistance, Bacterial; Drug therapy; Escherichia coli Infections - drug therapy; Humans; India; Klebsiella Infections - drug therapy; Neutropenia; Neutropenia - complications; Physiological aspects; Pseudomonas Infections - drug therapy; India
• ISSN: 0019-509X; 1998-4774
• DOI: 10.4103/0019-509X.175362

Carbapenem resistance is a growing global concern. There is a lack of published clinical studies on the topic from Indian subcontinent. Aim of this study was to analyze clinical profile of patients with carbapenem sensitive and resistant bacteremia among neutropenic and nonneutropenic patients. Retrospective analysis of 141 patients who had carbapenem resistant or sensitive Gram-negative bacteremia, identified over a period of 1-year was done by medical records review, in Apollo Specialty Hospital, a 300-bedded tertiary care Oncology, neurosurgical and orthopedic center in South India. Of the total 141 patients with Gram-negative bacteremia, 44 had carbapenem resistant ones. Of these 44 patients, 17 were neutropenics (resistant neutropenic group) and 27 nonneutropenic patients (resistant nonneutropenic group). Of the 97 patients with carbapenem sensitive bacteremia, 43 were neutropenic (sensitive neutropenic group) and 54 nonneutropenics (sensitive nonneutropenic group). The 28 days mortality was significantly higher in carbapenem resistant bacteremic group compared to the sensitive one (P = 0.008). This is the first study from India comparing clinical features of patients with carbapenem sensitive and resistant blood stream infections. Patients with carbapenem resistant bacteremia had higher mortality compared to patients with sensitive bacteremia.