Febrile neutropenia in a bone marrow transplantation unit

In our clinic, between May 1988 and December 1994, 117 bone marrow transplants (78 allogenic BMT (alloBMT), 26 autologous BMT (autoBMT), 13 autologous peripheral stem cell transplant (autoPSCT). Eighty-six (73.5%) febrile neutropenic episodes (FNEs) were encountered (64 alloBMTs, 15 autoBMTs, 7 autoPSCTs). There were 28 (32.5%) microbiologically documented infections, 18 (20.9%) clinically documented infections and 40 (46.5%) FUO. Gram-positive microorganisms were the most frequently isolated agents (57.1%) and Staphylococcus spp. were the main pathogens to cause bacteremia (%54.1). Enterobacter spp. were the most common (75%) in urinary tract infections, FNEs were most frequently (82%, 64 78 ) encountered in AlloBMT patients. No significant difference in the number of FNEs was found between autoBMT and autoPSCT groups (P < 0.05). Overall response rate to empirical antibiotherapy was 87.2% (75 86 ) and the success of treatment disclosed no difference in relation to transplant type and definition of infection (P > 0.05). Seven (6%) patients suffered from catheter infections and eight (7%) from Candida esophagitis.