Perfil microbiológico en pacientes con mieloma múltiple que presentaron neutropenia febril durante trasplante autólogo de precursores hematopoyéticos: descripción de una serie de casos
Microbiological profile in patients with multiple myeloma who developed febrile neutropenia during autologous hematopoietic stem cell transplantation
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Las unidades de trasplante de precursores hematopoyéticos deben conocer su perfil epidemiológico con el fin de ajustar los protocolos de antibiótico en neutropenia febril. Objetivo: describir los aislamientos microbiológicos relacionados con los eventos de neutropenia febril de una serie de casos de pacientes con mieloma múltiple durante la hospitalización por trasplante autólogo de precursores hematopoyéticos. Métodos: se realizó un análisis descriptivo de datos retrospectivos de una serie de 62 pacientes con neutropenia febril, hospitalizados por trasplante autólogo de precursores hematopoyéticos durante el periodo comprendido entre el 1° de enero del 2020 y junio del 2021. Resultados: el 50 % de los pacientes tuvo un foco infeccioso documentado, de los cuales el 70.9 % fue por prueba microbiológica positiva y el restante por razón clínica. De aquellos identificados por laboratorio, la bacteriemia fue el principal foco (19/62), seguida por la gastroenterocolitis (9/31). De los microorganismos aislados en hemocultivo el más frecuente fue S. epidermidis (14/19). Conclusiones: la mitad de los pacientes con neutropenia febril presentaron foco infeccioso documentado, la mayor parte bacteriemia por cocos Gram positivos coagulasa negativa, con baja prevalencia de gérmenes Gram negativos y de hongos. Independiente del subtipo de aislamiento hubo una baja prevalencia de desenlaces adversos en este grupo de pacientes.
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