Cases Of Bacteremia Research Articles

Burkholderia vietnamiensis causing bacteremia in patients suffering from B-cell acute lymphocytic leukemia: A case series and review of literature

Burkholderia cepacia complex consists of 24 species of microorganisms that include B. cepacia, B. multivorans, B. cenocepacia, B. vietnamiensis, B. ambifaria, and many more. It is a ubiquitous microorganism found in the soil and aquatic milieu. The probability of infections in immunocompetent individuals is rare, but an increase in the population of immunocompromised patients in the past decade has attributed to increasing incidence of infections caused by these microorganisms. The most common infections caused by these isolates include bacteremia, pneumonia, genital tract infections, and surgical wound infections. Their potential to cause nosocomial outbreaks in wards of immunocompromised patients is well known. In this case series, we describe three cases of community-acquired Burkholderia vietnamiensis bacteremia in patients suffering from B-cell acute lymphocytic leukemia and their antibiotic sensitivity pattern to guide the treatment of these individuals.

Clinical impact of the accelerate PhenoTest® BC system on patients with gram-negative bacteremia and high risk of antimicrobial resistance: a prospective before-after implementation study

BackgroundThe Accelerate PhenoTest® BC system (AXDX) is a novel assay for rapid bacterial identification and antimicrobial susceptibility (AST). We report an evaluation of its impact on treatment of patients with Gram-negative bacteremia (GNB) with a high risk of antimicrobial resistance (AMR).MethodsA prospective single-center evaluation before and after implementation of AXDX in addition to standard-of-care (SOC) microbiology and antimicrobial stewardship program (ASP). Patients with GNB reported during laboratory working hours and prespecified risk factors for AMR were included. The primary outcome was an ASP-oriented beneficial antimicrobial change, defined as either an escalation of an inappropriate empiric treatment or de-escalation of a broad-spectrum treatment of a susceptible organism. Main secondary outcomes were time to an appropriate treatment, antimicrobial treatment duration, length of stay (LOS) and mortality.ResultsIncluded were 46 and 57 patients in the pre- and post-intervention periods, respectively. The median time to an AST-oriented beneficial change was 29.2 h vs. 49.6 h, respectively (p < 0.0001). There were no significant differences in the time to appropriate treatment, LOS or mortality. Antimicrobial treatment duration was longer during the intervention period (10 vs. 8 days, p = 0.007). AXDX failed to correctly identify pathogens in all 6 cases of polymicrobial bacteremia. In two cases patient care was potentially compromised due to inappropriate de-escalation.ConclusionsAXDX implementation resulted in a 20.4-hour shorter time to an ASP-oriented beneficial antimicrobial change. This should be weighed against the higher costs, the lack of other proven clinical benefits and the potential harm from mis-identification of polymicrobial bacteremias.

Simplified antibiotic guidelines in urology are associated with decreased multidrug-resistant Enterobacterales

PurposeA simplified therapeutic guideline (STG) was established in our urology ward in 2019 for urinary infections. Our aim was to describe the level of physician adherence to STG and the impact of a limited number of antibiotic compounds on the rate of multidrug-resistant (MDR) bacteria. As guidelines should improve patient care, unfavorable outcomes were also reported. MethodsThe STG for community-acquired and nosocomial urinary infections, including six antibiotics, was established in November 2019 and has been officially applied since January 2020. Treatment duration has to be ≤14 days. We conducted a before-after study to measure physician adherence to the STG for bacteremia treatment between January 2017 and December 2022. Adherence was defined as exclusive use of STG antibiotics. All isolated bacteria from blood cultures were recorded, including MDR Enterobacterales, defined as AmpC β-lactamase- or ESBL-producing strains. Unfavorable outcomes were defined as uncontrolled infection, a second surgical procedure, ICU requirement, and/or death. ResultsSeventy-six cases of bacteremia occurred between January 2017 and December 2019, and ninety between January 2020 and December 2022. The main comorbid condition was urological cancer (46%). The main reason for surgery was ureteral stent (32%). Antibiotic management in accordance with STG increased from 18% to 52%, p < 0.001, and treatments > 14 days decreased from 53% to 28%, p < 0.001. MDR Enterobacterales bacteremia was reduced from 52% to 35%, p = 0.027. The rate of unfavorable outcomes was unchanged. ConclusionSTG adherence in urology was satisfactory and associated with reduced MDR Enterobacterales bacteremia.

First Case of Meningoencephalitis and Bacteraemia with Flavobacterium Lindanitolerans.

Flavobacterium lindanitolerans is an environmental Gram-negative, non-spore-forming rod which is usually not considered to be a human pathogen. Isolation from human clinical samples has been described only once. We report the first case of meningoencephalitis and bacteraemia with Flavobacterium lindanitolerans. A 76-year-old female presented with fever, headache, alteration of mental status, marked meningism and dysarthria. A lumbar puncture demonstrated cerebrospinal fluid findings consistent with bacterial meningitis, and a broad-spectrum antibiotic therapy was initiated. Blood and cerebrospinal fluid cultures revealed a growth of Flavobacterium lindanitolerans. Based on antimicrobial susceptibilities testing, antibiotic treatment was changed to levofloxacin, resulting in a remission of the clinical symptoms after 21 days of treatment. Flavobacterium species are extremely rare human pathogens. However, some of them have been reported to cause opportunistic infections. We describe the first case of meningoencephalitis and bacteraemia caused by Flavobacterium lindanitolerans which was effectively treated with levofloxacin for 21 days. This is the first case of a meningoencephalitis and bacteraemia with Flavobacterium lindanitolerans.Levofloxacin can be given for 21 days as a treatment of F. lindanitolerans.

Endoscopic Retrograde Cholangiopancreatography in Children: Nine Years' Experience at Santa Fe Foundation in Bogota, Colombia.

Experience in the use of diagnostic and/or therapy of endoscopic retrograde cholangiopancreatography (ERCP) in children is limited. This is due to the underdiagnosis of pancreaticobiliary disease in the pediatric population and specialist personnel in this procedure. To determine the safety and success rate of ERCP in children at Hospital Fundación Santa Fe de Bogotá between January 2007 and June 2015. This was an observational, descriptive, retrospective case series study of patients under 18 years, who underwent ERCP between January 2007 and June 2015. The following variables were analyzed: indication, duration, type of procedure, rate of success, and complications. A total of 30 patients were included, in whom 65 ERCP procedures were performed. Successful cannulation was achieved in 52 of the 65 procedures (80%). Among the complications that occurred, there were four cases of pancreatitis (6.2%), two cases of bleeding (3.1%), and one case of bacteremia (1.5%), and in most cases (58 in total, 89.2%), there were no complications. The pediatric gastroenterology group of the Fundación Santa Fe de Bogotá has obtained good results in performing ERCP in the pediatric population with a success rate of 80% associated with a null mortality rate. There is enough literature available to conclude that performing ERCP in the pediatric population maintains an adequate success rate and a low complication rate. In all the studies evaluated, a null mortality rate was found, so it is considered that this procedure is safe in patients under 18 years of age.

Vancomycin-sensitive Enterococcus faecium bacteraemia - hospital transmission and mortality in a Danish University Hospital.

Introduction. The emergence of vancomycin-resistant Enterococcus faecium (VREfm) has left the vancomycin-sensitive E. faecium (VSEfm) strains almost unnoticed.Hypothesis. Molecular characteristics, hospital transmission patterns and clinical impact of VSEfm have changed, and VSEfm is a predictor of VREfm introduction.Aim. We wanted to do a molecular characterization of VSEfm to identify hospital transmissions and links between VSEfm and VREfm, and to investigate the demographics, treatment and impact on mortality of VSEfm bacteraemia.Methodology. VSEfm and VREfm blood culture isolates from Odense University Hospital, Denmark, from 2015 to 2019 were characterized using whole-genome sequencing and core-genome multilocus sequence typing (cgMLST). Clonal shifts and diversity of the VREfm isolates were compared to the VSEfm isolates. Hospital records were used for clinical data and transmission investigation of VSEfm cases.Results. Six-hundred and thirty VSEfm isolates from 599 patients belonged to 42 sequence types (STs) and 131 complex types (CTs) in several clusters. Multiple types were involved in putative transmission, occurring over the entire period. Twenty-seven VREfm bacteraemia cases were included. No correlation between the VSEfm and VREfm clones was identified. The 30 day mortality was 40 %, but only in 6.3 % of the cases, VSEfm bacteraemia was the likely cause of death.Conclusion. The molecular types of VSEfm bacteraemia isolates are changing and diverse. No direct correlation between VSEfm and the introduction of VREfm was found, but widespread hospital transmission indicates a presence of risk factors that could facilitate transmission of other micro-organisms as well. VSEfm bacteraemia is rarely the cause of death, indicating that 30 day mortality does not reflect the cause of death.

An investigation of household dogs as the source in a case of human bacteraemia caused by Staphylococcus pseudintermedius

ABSTRACT Staphylococcus pseudintermedius is a commensal and an opportunistic pathogen in dogs, and is also an opportunistic pathogen in humans. Here we report about a case of bacteraemia with a fatal outcome in a 77-year-old co-morbid male likely caused by a S. pseudintermedius and the investigation into the possible transmission from the two dogs in the patient’s household. The two dogs carried the same S. pseudintermedius strain, but this dog strain was unrelated to the strain from the patient. In contrast to the patient strain, the dog strain showed reduced susceptibility to several antibiotics and both dogs had received antibiotic treatment prior to sampling. So, it is conceivable that these treatments can have eliminated the patient’s strain between the transmission event and the dog sampling. It is also worth noting that the patient strain was positive for the expA gene, which encodes an exfoliative toxin closely related to the S. aureus exfoliative toxin B. This toxin has been linked to canine pyoderma, but its effect on humans remains unknown. Transmission of S. pseudintermedius was confirmed in the household between the dogs. However, we could not verify that the dogs were the source for the S. pseudintermedius in the patient.

A Rare Case of Bacteremia caused by Ochrobactrum anthropi in Patient with Chronic Kidney Failure Treated by Hemodialysis

Ochrobactrum anthropi, previously known as "Achromobacter group Vd", is a gram-negative, non-lactose-fermenting, obligate aerobic, indole-negative, oxidase-positive, urease-positive, motile bacillus. In recent years, it has emerged as a nosocomial infection agent especially in central venous catheters in both immunosuppressed and immunocompromised individuals. In this case report, a 56-year-old female patient who underwent dialysis for two days a week due to chronic kidney failure and had O. anthropi isolated in blood culture samples taken after fever increased is presented. In conclusion, it should be kept in mind that unusual microorganisms such as catheter-related O. anthropi may appear as causative agents in patients undergoing dialysis due to renal failure.

The first case of Janibacter bacteremia in pregnancy: A case report and review

Clinical infection with Janibacter species is an infrequently reported event. There are a small number of cases of patients with Janibacter bacteremia recognized to date. We report the first case of Janibacter bacteremia in a pregnant woman. The bacteremia was associated with pneumonia. Such cases can be difficult to manage due to the lack of antibiotic susceptibility data for these bacteria. We also report susceptibility data for the Janibacter hoylei that was isolated in our patient. This case demonstrates that J. hoylei can be a pathogen in otherwise immunocompetent pregnant women.

P23 Rates, treatment and outcomes of vancomycin-resistant Enterococcus faecium bacteraemia at Addenbrooke’s Hospital

Abstract Background Vancomycin-resistant Enterococcus faecium (VRE-fm) bacteraemias represent important nosocomial infections with significant associated mortality and morbidity. Objectives To (i) describe the rates, treatments, and outcomes of VRE-fm bacteraemia at Addenbrooke’s Hospital in 2020–21 and compare to a cohort from 2006 to 2012 and (ii) describe rates of antibiotic resistance in VRE-fm bacteraemia isolates from 2015 to 2021. Methods 71 eligible adult patients with positive VRE-fm blood cultures from 2020 to 2021 were compiled, and electronic patient notes were reviewed retrospectively to obtain microbiological and clinical data. These were compared to a cohort of 187 patients from 2006 to 2012. A nine-person paediatric cohort from 2020 to 2021 was analysed separately. Antibiotic resistance rates were calculated among VRE-fm isolates from blood cultures collected from 2015 to 2021. Results A non-significant increase in VRE-fm bacteraemia cases was observed in 2020–2021. Patients were on average, older, with different spectrums of comorbidities. Despite similar Charlson Comorbidity Indices and Pitt Bacteraemia Scores, they also demonstrated a significant reduction in 30-day crude mortality from 34% to 18% (P = 0.015). This effect could be accounted for by a lower frequency of risk factors for mortality, such as renal and liver diseases in the 2020–21 cohort. Conversely, treatment with daptomycin was used more commonly among the 2020–21 cohort and was associated with greater survival. Conclusions Improved 30-day all-cause mortality in patients with VRE-fm bacteraemia were noted in 2020–21 compared with a historical 2006–12 cohort. High numbers of VRE-fm bacteraemia of nosocomial onset remain a significant concern from both an infection control and antimicrobial stewardship perspective.

First case of persistent Stenotrophomonas maltophilia bacteraemia due to septic thrombosis successfully treated with a cefiderocol-containing regimen

There is scarce evidence in literature of what should be the best antimicrobial treatment for bloodstream infections (BSIs) sustained by Stenotrophomonas maltophilia, a peculiar pathogen that intrinsically withstands to most of the available antibiotics. Here, we describe a challenging case of a persistent S. maltophilia BSI due to septic thrombosis successfully treated with the addition of the novel siderophore cephalosporin cefiderocol to an only partially effective levofloxacin regimen. Additionally, an intra-lock therapy with trimethoprim/sulfamethoxazole was selected as a strategy to prevent recurrence of infection since complete source control was not possible. The serum bactericidal assay was also used to corroborate the in vivo efficacy of the adopted combination therapy.

Addition of doxycycline to fluoroquinolones for bacterial prophylaxis in autologous stem cell transplantation for multiple myeloma.

e18732 Background: Autologous stem cell transplant (ASCT) is standard therapy for patients (pts) with multiple myeloma (MM), yet the risks of such treatment include neutropenic fever (NF) and bacteremia. Fluoroquinolones (FQs) are a mainstay of bacterial prophylaxis (ppx) of NF in ASCT at many transplant centers and reduce the incidence of bacteremia. Nevertheless, ppx regimens for ASCT are not standardized and variability exists even within single institutions. While antibacterial ppx decreases infections, antibiotic use can also cause toxicity, resistance, and microbiome disturbance. The addition of doxycycline (doxy) to FQs was previously linked to reduced NF and bacteremia when utilized for ppx in MM pts at our institution, leading some providers to incorporate doxy into their ppx regimens. However, our prior study introduced multiple confounders, including differing pre-transplant conditioning regimens between ppx groups. We sought to further compare the incidence of NF and bacteremia in MM pts receiving ppx with FQ alone and FQ-doxy during a time when ppx strategies varied but transplant conditioning was consistent between groups. Methods: This is a single institution retrospective review. We analyzed all medical charts in the ASCT database of MM pts treated at our institution between Jan 2016 and Dec 2021. The primary objective was to determine the effect of bacterial ppx on the rate of NF and bacteremia within 30 days of ASCT. Data was also collected on several pt characteristics. Results: Out of 341 pts with MM who underwent ASCT following melphalan (mel) conditioning, 121 received FQ (ciprofloxacin or levofloxacin) ppx and 220 received FQ-doxy ppx. Pt characteristics and outcomes of interest are shown in Table 1. NF developed in 71 (58.7%) and 103 (46.8%) pts in the FQ and FQ-doxy groups, respectively (p = 0.042). The odds of NF in FQ-doxy compared to FQ is 0.62 (95% CI 0.4, 0.97). Bacteremia developed in 7 (5.8%) and 6 (2.7%) pts of the FQ and FQ-doxy groups (p = 0.235). The odds of bacteremia in FQ-doxy compared to FQ is 0.46 (95% CI 0.15, 1.39). Documented bacteremia was infrequent, yet resistance profiles demonstrated FQ-resistant E. coli strains in the 7 total Gram-negative bacteremia cases and 5 extended-spectrum beta-lactamases. Conclusions: Overall, there were fewer cases of NF in the FQ-doxy ppx group than FQ, however there was no significant difference in the cases of bacteremia. This finding does not support the addition of doxy to FQ ppx at our institution and a future randomized controlled trial investigating appropriate ppx for ASCT is warranted. [Table: see text]

An 11-Year Review of Lactobacillus Bacteremia at a Pediatric Tertiary Care Center.

To inform clinical decisions on the use of probiotics in a pediatric inpatient setting, we sought to determine the number of cases of Lactobacillus bacteremia as well as associated patient characteristics in a tertiary-care pediatric hospital over an 11-year period. Cases of Lactobacillus bacteremia among admitted patients were identified through positive blood culture reports. The clinical chart for each case was reviewed for presenting symptoms and risk factors such as probiotic use, presence of a central venous catheter, immunocompromised state, impaired intestinal function, and age below 3 months. Concurrent total inpatient probiotic administration was assessed. Over an 11-year period, 8 cases of Lactobacillus bacteremia were identified among 127 845 hospital admissions. All cases were associated with systemic signs of infection. Lactobacillus bacteremia patients most frequently had underlying impaired intestinal function and a central venous catheter. Three cases had a history of probiotic use. The peak number of annual cases did not coincide with the peak number of inpatients who received probiotics. Lactobacillus bacteremia is uncommon and did not correlate with doses of probiotics-administered in the hospital. However, certain populations may be at higher risk and require extra consideration in clinical decision-making regarding use of probiotics.

Comamonas testosteroni: A Rare Case of Bacteremia in a Patient with Chronic Liver Disease

Comamonas testosteroni: A Rare Case of Bacteremia in a Patient with Chronic Liver Disease

Bacteremia During the First Year After Solid Organ Transplantation: An Epidemiological Update.

There are limited contemporary data on the epidemiology and outcomes of bacteremia in solid organ transplant recipients (SOTr). Using the Swiss Transplant Cohort Study registry from 2008 to 2019, we performed a retrospective nested multicenter cohort study to describe the epidemiology of bacteremia in SOTr during the first year post-transplant. Of 4383 patients, 415 (9.5%) with 557 cases of bacteremia due to 627 pathogens were identified. One-year incidence was 9.5%, 12.8%, 11.4%, 9.8%, 8.3%, and 5.9% for all, heart, liver, lung, kidney, and kidney-pancreas SOTr, respectively (P = .003). Incidence decreased during the study period (hazard ratio, 0.66; P < .001). One-year incidence due to gram-negative bacilli (GNB), gram-positive cocci (GPC), and gram-positive bacilli (GPB) was 5.62%, 2.81%, and 0.23%, respectively. Seven (of 28, 25%) Staphylococcus aureus isolates were methicillin-resistant, 2/67 (3%) enterococci were vancomycin-resistant, and 32/250 (12.8%) GNB produced extended-spectrum beta-lactamases. Risk factors for bacteremia within 1 year post-transplant included age, diabetes, cardiopulmonary diseases, surgical/medical post-transplant complications, rejection, and fungal infections. Predictors for bacteremia during the first 30 days post-transplant included surgical post-transplant complications, rejection, deceased donor, and liver and lung transplantation. Transplantation in 2014-2019, CMV donor-negative/recipient-negative serology, and cotrimoxazole Pneumocystis prophylaxis were protective against bacteremia. Thirty-day mortality in SOTr with bacteremia was 3% and did not differ by SOT type. Almost 1/10 SOTr may develop bacteremia during the first year post-transplant associated with low mortality. Lower bacteremia rates have been observed since 2014 and in patients receiving cotrimoxazole prophylaxis. Variabilities in incidence, timing, and pathogen of bacteremia across different SOT types may be used to tailor prophylactic and clinical approaches.

Vogesella urethralis-induced aspiration pneumonia and bacteremia in an elderly man: a first case report and literature review

BackgroundVogesella species are common aquatic Gram-negative rods that were first reported in 1997. Vogesella urethralis bacterium was first isolated from human urine in 2020. Only two cases of disease caused by Vogesella species have been reported with no case of Vogesella urethralis-caused disease being reported as yet. Herein, we report a case of aspiration pneumonia and bacteremia caused by Vogesella urethralis.Case presentationAn 82-year-old male patient was admitted with dyspnea, increased sputum production, and hypoxia. Gram-negative rods were isolated from the blood and sputum cultures of the patient. He was diagnosed with aspiration pneumonia and bacteremia. Initially, Vogesella urethralis was wrongly identified as Comamonas testosteroni based on fully automated susceptibility testing; however, additional 16S rRNA gene sequencing identified the causative as Vogesella urethralis. The patient was treated with piperacillin and tazobactam. Unfortunately, he developed aspiration pneumonia again and died during hospitalization.ConclusionsSince no database exists for rare bacteria in traditional clinical microbiology laboratories, 16S rRNA gene sequence analysis is useful. We report the first case of Vogesella urethralis-induced aspiration pneumonia and bacteremia.

Characteristics and Treatment of Gordonia spp. Bacteremia, France

Systemic Gordonia spp. infections are rare and occur mostly among immunocompromised patients. We analyzed 10 cases of Gordonia bacteremia diagnosed in 3 tertiary care centers in France to assess risk factors, treatment, and clinical outcomes. Most patients were cured within 10 days by using β-lactam antimicrobial therapy and removing central catheters.

Predictors of Central Vascular Access Device Bloodstream Infections in Patients With Acute Leukemia and Neutropenia: A Retrospective Case-Control Chart Review.

Central vascular access devices (CVADs) are standard for the treatment of leukemia. The objectives of this study were to examine predictors for central line-associated bloodstream infection (CLABSI) and causative microorganisms. A retrospective case/control design was used to examine electronic health records (EHRs) of patients with acute leukemia, a CVAD, and neutropenia. Variables were examined for differences between those who developed bacteremia (cases: n = 10) and those who did not (controls: n = 13). Variables included conditions of health (eg, patient history, laboratory results at the time of nadir, nutritional intake during hospitalization, and CVAD care practices). Fisher exact and Mann-Whitney U tests were used for comparison. Nine organisms were identified, including viridans group streptococci (20%) and Escherichia coli (20%). No statistical differences in variables were found between groups. However, over 50% of the nutritional intake data was missing due to lack of documentation. These findings indicate that further study is needed to examine barriers for electronic documentation. The data collection site found opportunities to improve patient care that included education regarding the daily care of CVADs, collaboration with nutritional services to ensure accurate assessments, and coordination with clinical information systems to improve clinical documentation compliance.

COMPARISON OF CLINICAL, LABORATORY FINDINGS AND COMPLICATIONS IN BACTERIEMIC AND NONBACTERIEMIC BRUCELLOSIS: A SINGLE CENTER EXPERIENCE

Objective: Brucellosis is a systemic zoonosis that affects various organs or body systems and can mimic many diseases. Symptoms can range from acute febrile illness to chronic clinical manifestations with severe complications. In our study, we investigated the relationship between bacteremia and clinical and laboratory findings, and complications in patients with brucellosis.&#x0D; Material and Methods: Two hundred and twenty-three patients diagnosed with brucellosis between 2005 and 2020 in the department of infectious diseases and clinical microbiology of a tertiary care university hospital were included in the study. Rose Bengal test, Brucella standard tube agglutination test and culture (blood and/or bone marrow culture) were used for the diagnosis of brucellosis. The patients were divided into two groups according to their bacteremia status. Patients with positive culture were identified as bacteremia, and patients with negative culture were identified as non-bacteriemic.&#x0D; &#x0D; Results: A total of 223 patients were included in the study, of which 142 (63.7%) were male. While weight loss, fever and hematological complications were higher in bacteremia cases (p=0.001, p

Bacterial ecology of sepsis in febrile neutropenics on hematology-oncology services

Introduction: Febrile neutropenia is a hematologic emergency that develops following treatment of hematologic malignancies. It exposes patients to the risk of sepsis, which is a major cause of morbidity and mortality. Currently, coagulase-negative staphylococci are the most common bloodborne isolates while enterobacteria are isolated less frequently. The objective of our study is to determine the epidemiological, bacteriological and antibiotic susceptibility profile of strains isolated from blood cultures collected from febrile neutropenic patients at Hassan II University Hospital, Fez. Materials and methods: This is a prospective study, over a period of 4 years (January 2019 - December 2022) including 83 patients with bacteremia hospitalized in the department of hemato-oncology. Identification and detection of antibiotic resistance was performed according to conventional bacteriology methods and CA-SFM/EUCAST recommendations. Results: Among 524 blood cultures received, we diagnosed 83 cases of bacteremia. The average age of the patients was 55 years. The average age of the patients was 55 years. The predominance of women was noted, with a sex ratio of 0.88. The majority of the episodes, 94.87%, occurred in patients followed for a neoplastic pathology. Hematological malignancies were the most responsible with a rate of 61.54% against 33.33% of solid tumors. Gram-positive bacteria represent 56.6%, and 43.4% of Gram-negative bacteria. The proportions of the different bacterial classes (BGN / CG+) have remained stable over the last 4 years, Staphylococcus epidermidis was the most frequent isolated Gram-positive bacteria 24.1℅(n=29) then Staphylococcus aureus 24.6% (n=18), followed by Gram-negative bacteria of enterobacteria type especially Escherichia coli which was the most frequently isolated pathogen (16.86%), followed by Klebsiella pneumoniae (10.84℅) and non-fermenting Gram-negative bacteria such as Pseudomonas aeruginosa (8.4) and Acinetobacter baumanii (6℅). Bacteria of clinical interest have shown increasingly worrisome levels of beta-lactam resistance, with extended-spectrum beta-lactamase (ESBL)-producing strains of Klebsiella pneumoniae accounting for 4, 8% with only one case of carbapenemase, meticillin-resistant Staphylococcus aureus was 3.61% while no imipenem-resistant Pseudomonas aeruginosa or vancomycin-resistant enterococci were found. While Acinetobacter baumanii isolates (n=5) showed increased resistance to the majority of antibiotics tested, especially to imipenem which was 100%. Discussion and conclusion: Gram-positive bacteremia of the genus coagulase-negative staphylococcus is the most common type of infection in febrile neutropenias showing an increasingly resistant profile to first-line antibiotics. However, Gram-negative infections have shown decreased susceptibility compared to previous years. A regular study of the bacterial ecology of blood culture isolates and a determination of antibiotic susceptibility are necessary to optimize the probabilistic antibiotic therapy of bacteremia.