Infections in Patients with Acute Leukemia

Shin, Dong Hyeon; Kim, Jin Wook; Oh, Myoung Don; Kim, Eui Chong; Park, Seon Yang; Kim, Byung Kook; Choe, Kang Won

Abstract

BACKGROUND
Infection is the major life-threatening complication of acute leukemia. For the empirical treat-ment of infections in acute leukemia, monitoring of the patterns and trends of the infectious complications is im-portant.
METHODS
We prospectively evaluated the febrile epi-sodes in patients with acute leukemia who were admitted to the Seoul National University Hospital during the period from January 1997 to December 1997.
RESULTS
Seventy-eight febrile episodes in 56 patients were evaluated. Seventy percent of the febrile episodes were associated with chemotherapy, and 90% of them occurred during the neutropenic period. Common sites of infections were the gastrointestinal tract, followed by oropharynx, central venous catheter, perianal area, skin and soft tissue, blood stream, lung, paranasal sinus, liver, and urinary tract. Sixty-six percent of microbiologically- documented infections were caused by gram-negative organisms, and 26% by gram-positive organisms. Escheri-chia coli was the most common pathogen, and Staphy-lococcus aureus, Klebsiella pneumoniae, Enterobacter cloacae, Staphylococcus ep idermidis, Streptococcus species were common in decreasing order. Ninety-one percent of the total infections were controlled with antimicrobial therapy.
CONCLUSION
The gastrointestinal tract was the most frequent site of infections in acute leukemic patients. Gram-negative organisms were responsible for 66% of the microbiologically documented infections. Ninety-one percent of the infectious complications were controlled with antimicrobial therapy.