Keywords
Antimicrobials
Mortality
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Abstract
Objective: To describe the clinical, microbiological, and antimicrobial resistance profile of hospitalized oncology patients with febrile neutropenia in a private hospital, as well as to identify factors associated with in-hospital mortality. Methods: A retrospective observational study was conducted at a private hospital in Campo Grande, Mato Grosso do Sul, Brazil, including adult and elderly patients with solid or hematological malignancies who received antimicrobial therapy for suspected febrile neutropenia between January 2024 and June 2025. Descriptive and analytical statistics were performed using odds ratio (OR) estimates. The primary outcomes were hospital discharge and in-hospital mortality. Results: A total of 61 patients were included, with a predominance of females (57.4%) and hematological malignancies (72.1%). Blood cultures were positive in 15.9% of cases, mainly for Klebsiella pneumoniae, coagulase-negative Staphylococcus, and Pseudomonas aeruginosa. Resistance to fluoroquinolones, cefepime, and piperacillin–tazobactam was frequent. The overall case fatality rate was 27.9%. Positive blood cultures (OR = 12.6; p < 0.01) and admission to the intensive care unit (OR = 17.9; p < 0.001) were significantly associated with mortality. Conclusion: Oncology patients with febrile neutropenia presented a high burden of bacterial infections and relevant antimicrobial resistance profiles. Positive blood cultures and the need for intensive care were the main predictors of mortality, reinforcing the importance of continuous microbiological surveillance and early intensive management.
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