A Study on the Microbiological Profile of Bloodstream Infections and the Seroprevalence of Herpes Simplex Virus in Hematological Malignancy Patients in a Tertiary Care Hospital

INTRODUCTION: Blood stream infections are an important cause of mortality among patients with hematological malignancies. Blood culture is the gold standard test for the detection of bacteremia. Herpes Simplex Virus is the most common viral infection encountered among them. AIM OF THE STUDY: The aim of this study is to identify the microbial profile of blood stream infections in hematological malignancy patients and to determine the prevalence of Herpes Simplex Virus infection among them. MATERIALS AND METHODS: A total of 100 patients were included in the study carried out at the Institute of Microbiology, Madras Medical College, in association with the Department of Hematology, Rajiv Gandhi Government General Hospital, and Chennai. RESULTS: The incidence of BSI in patients with hematological malignancy patients was 24%. Patients with AML accounted for majority of the study population (42%) and BSI was seen in higher proportion in them (62.5%). Most common age group associated with BSI were 41-50 years (29.1%). The most frequent source of bacteremia was the Respiratory tract (37.5%), followed by urinary tract (25%). In 4 patients, (16.7%) primary blood-stream infection was documented. Incidence of BSI was found to be higher, 34.7% in patients who were neutropenic during the course of chemotherapy. Among the bacterial isolates, Gram negative organisms were found to be predominant (54.1%), while Gram positive organisms constituted 41.6%. Pseudomonas aeruginosa (16.6%) was the most common isolate among GNB. Among the Gram positive organism, Staphylococcus aureus was the most frequent organism (20.8%). Candida albicans was isolated in 1 patient. HSV 1/2 IgM antibodies was seen in 8.9% of patients and IgG antibodies was seen in 43.3% of patients detected by ELISA. The overall mortality rate in patients with BSI was 28.1%. CONCLUSION: The severity of malignant hematological disease, intensive immunosuppressive chemotherapy, duration of neutropenia, resistant mechanisms in bacteria contributed to the mortality among patients with BSI. Continual surveillance of the resistant pathogens in these hematological malignancy patients and antimicrobial therapy will add to improve the survival rate of patients with sepsis