Microbiological profile evolution in patients with acute lymphoblastic leukemia

Introduction: Infections during chemotherapy cycles in patients with acute lymphoblastic
leukemia (ALL) are a common complication, particularly during periods of treatment-
induced neutropenia. Several studies have reported an increase in infections caused by
multidrug-resistant bacteria, posing a significant challenge in clinical management. Materials
and Methods: A retrospective, cross-sectional, and analytical study was conducted, including
patients over 16 years old with a confirmed diagnosis of ALL and at least one positive blood
culture. Bacterial isolates and their association with mortality were analyzed using
descriptive statistics and logistic regression to identify associated factors. Results: A total of
110 isolates were identified, with Escherichia coli and Klebsiella pneumoniae being the most
common species, followed by Staphylococcus aureus and Staphylococcus epidermidis.
Opportunistic pathogens such as Burkholderia spp. and Stenotrophomonas maltophilia
showed a stronger association with mortality. Multivariate regression revealed that
Burkholderia spp. was independently associated with increased risk of death. Discussion:
Over time, the bacterial profile in patients with ALL has evolved, although certain pathogens
remain prevalent across different periods. This highlights the importance of updating
neutropenia management protocols according to the bacteriological epidemiology of each
center. In our hospital, Burkholderia spp. and Stenotrophomonas maltophilia were identified
as the most lethal bacteria,