Tailoring antimicrobials in febrile neutropenia: using faster diagnostic and communication tools to improve treatment in the era of extensively resistant pathogens.

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The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases, ISSN: 1678-4391, Vol: 22, Issue: 3, Page: 239-242

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Souza, Ingvar Ludwig Augusto de; Quiles, Milene Gonçalves; Boettger, Bruno Cruz; Pignatari, Antonio Carlos Campos; Cappellano, Paola
Elsevier BV
article description
Febrile Neutropenia represents a medical emergency and the use of appropriate antimicrobial therapy is essential for a better outcome. Although being time-consuming, conventional cultures and antimicrobial susceptibility tests remain the golden standard practices for microbiology identification. Final reports are typically available within several days. Faster diagnostic tools, such as species identification trough Matrix Assisted Laser Desorption Ionization-Time of Flight (MALDI-TOF) and molecular techniques might help to shorten time to diagnostic and also guide definitive therapy in this scenario. Here we present a case in which the use of a diagnostic molecular workflow combining MALDI-TOF and real-time PCR for relevant genes codifying antibiotic resistant integrated with instant communication report, led to a tailored and more appropriate treatment in a patient presenting with febrile neutropenia.