Work

Microbiological characterization of bacteremia in patients with chemotherapy-induced febrile neutropenia: systematic review and meta-analysis

Year: 2025

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Background: Febrile neutropenia (FN) is the most common and serious adverse event of chemotherapy for solid and hematological neoplasms, with infection as a major complication. FN occurs in 10%–50% of patients with solid tumors and over 80% with hematological malignancies, with mortality rates up to 11%. Objective: To characterize bloodstream pathogens in post-chemotherapy FN through a systematic review and meta-analysis of studies published from 2013 to February 13, 2024. Design: Systematic review and meta-analysis. Data sources and methods: PubMed, Web of Science, Scopus, and Embase were searched using MeSH, Emtree, and keywords. Risk of bias was assessed using the JBI checklist. Random-effects proportions meta-analysis was performed. Results: Twenty-two studies ( n = 23,319) reported 8665 positive blood cultures: 59% Gram-negative (95% CI: 46.8–67.5), 39.7% Gram-positive (95% CI: 31.3–48.2), and 2.5% fungi (95% CI: 0.9–4.1). Random-effects meta-analysis showed high heterogeneity ( I 2 = 98.92%, p < 0.01). Meta-regression by sample size, economic development, and risk of bias did not explain this variability. Conclusion: Gram-negative pathogens slightly predominate over Gram-positives in bloodstream infections among post-chemotherapy FN patients. Trial registration: PROSPERO (CRD42023472191).

Source: Therapeutic Advances in Infectious Disease

DOI: 10.1177/20499361251376123