Q06. What organisms cause infections in febrile neutropenic patients?
Summary: The relative incidence of pathogens responsible for causing infections in patients with febrile neutropenia has changed over the past two decades. Previously, Gram-negative bacteria were predominant, but now 60–70% of infections are caused by Gram-positive pathogens, with an increasing role seen for enterococci and streptococci including viridans streptococci. The rise of these pathogens is important because, although Gram-positive bacteria such as Staphylococcus do not usually cause significant infection in immunocompetent patients, they can cause serious complications in cancer patients. Therefore, it is important that these infections are treated seriously. In addition, although the incidence of Gram-negative pathogens has decreased, infections caused by these bacteria are associated with a higher mortality, making coverage of these pathogens important.