The role of blood culture in the management of febrile neutropenia in patients with hematological malignancies at Hiwa Hospital in Iraq

Abstract: BACKGROUND: We have some serious complications during the treatment of hematological malignancies that adversely affect the outcome. Febrile neutropenia (FN) is one of the most common serious complications that carry a mortality rate of 10%–34%. Conventional microbiological cultures are still routinely investigated to identify the offending microorganisms causing this condition, then to treat according to the results of sensitivity testing. At the same time, factors affecting this outcome need to be explored to lower this high mortality rate. OBJECTIVES: To evaluate the usefulness of blood culture (BC) in determining the antibacterial management plan in immunocompromised adult and pediatric patients being admitted with FN to Hiwa hospital in Sulaymaniyah. MATERIALS AND METHODS: A descriptive retrospective study done at Hiwa Hospital in Sulaymaniyah, Kurdistan region of Iraq on 402 FN episodes admitted to the hospital over 18 months studied. Several variables were taken within the patients through their electronic records being reviewed thoroughly. RESULTS: The positive cultures showed 6 (1.5%) sample fungal, 26 (6.5%) samples Gram-positive bacteria, and 34 (8.5%) sample Gram-negative bacteria. Age (odds ratio [OR] =1.027) ( P ≤ 0.001, confidence interval [CI]:95%: 1.01–1.042), duration of neutropenia (OR = 1.020) ( P ≤ 0.001, CI: 95%: 1.02–1.032), and hospital stay before BC (OR = 1.020) ( P ≤ 0.001, CI: 95%: 0.010–0.035) were the predictors of death in patients. CONCLUSIONS: The findings reveal that BC is still a useful intervention in the treatment of FN. Age, the duration of neutropenia, and length of stay in a hospital are the predictive factors of mortality.