Febrile Neutropenia in Yemeni Cancer Patients: Bacterial Spectrum and Antibiotic Susceptibility

Background : Febrile neutropenia (FN) is a life-threatening complication of chemotherapy. Understanding the common pathogens and antimicrobial susceptibility is essential for effective empirical therapy, especially in resource-limited settings. Objective: To identify bacterial spectrum and antibiotic susceptibility among FN cancer patients at Al-Amal Cancer Center, Taiz city, Yemen. Methods : A prospective study of 50 patients with FN was conducted between July 2022 and March 2023. A total of 92 cultures (blood, urine, throat swabs) were processed using the BACT/ALERT system. Isolates were identified using standard microbiological techniques, and antimicrobial susceptibility testing was performed. Results : Of 92 cultures, 28 (30.5%) were positive. Gram-positive bacteria predominated (83%), mainly Staphylococcus spp. (78.5%). Gram-negative organisms included E. coli (10.5%) and Klebsiella spp. (7%). Most Staphylococcus isolates were methicillin-resistant (MRSA), and 10% were vancomycin-resistant (VRSA). Cefepime demonstrated high resistance (>80%), whereas carbapenems and amikacin showed the highest sensitivity. The overall mortality rate was 12%. Conclusion : FN in this Yemeni cohort was primarily associated with multidrug-resistant Gram-positive bacteria. Cefepime showed poor activity, underscoring the need to revise empirical FN treatment protocols in favor of more effective agents, such as carbapenems and amikacin.