Multi Bacterial Infection in Immunocompromised Patient

Infection is a major cause of morbidity and mortality in immunocompromised cancer patients due to chemotherapy, radiotherapy, or anti-inflammatory therapy. Approximately 0.9%-39% of cancer patients with febrile non neutropenia has bacteremia and about 7.3% of cancer patients hospitalized have positive bacterial blood cultures. Multi-bacterial infection with Multi Drug Resistant (MDR) in immunocompromised cancer patients complicates therapy and is often fatal. A 6 years old boy diagnosed with left orbital tumor intracranial infiltration. Physical examination: lump in the left eye ± 8 x 10 cm, solid, reddish in color, there was a wound on the left eye ± 12 x 10 cm; Temperature 39⁰C. Hematology examination Hb 10.3 g / dL; PLT 156 x103 / uL; WBC 28.92 x103 / uL. Blood culture results: Methicillin Resistant Staphylococcus aureus (MRSA) resistant to Gentamicin, Amoxicillin Clavulanic Acid, Ampicillin, Penicillin G, Oxacillin and Enterococcus faecium resistant to Gentamicin, Ampicillin, Cotrimoxazole, Trimetoprim, Erythromycin, and Clindamycin. Results of pus culture from the left eye wound was Staphylococcus intermedius resistant to Gentamicin, Amoxicillin Clavulanic Acid, Ampicillin, Penicillin G, Oxacillin, Chloramphenicol, Ciprofloxacin. Based on the results of blood and pus culture, all bacterial isolates included multidrug-resistant organisms (MDRO). Multidrug resistant organisms are microorganisms, especially bacteria that are resistant to at least 1 antibiotic of three or more categories. Cancer patients are susceptible to infection with multi-drug resistant bacteria because of their decreased immune system, especially after undergoing chemotherapy. Appropriate antibiotic treatment determines patient morbidity and mortality. Infection due to multi-bacteria accompanied by multi-drug resistance in immunocompromised patients is a condition that has to be treated immediately since the onset of the disease to reduce morbidity and mortality.