Bacterial Infections in Neutropenic Cancer Patients in Iraq: A Cross-Sectional Study of Clinical and Microbiological Patterns

Neutropenia is a serious and frequent complication in cancer care, particularly following chemotherapy. It markedly increases the risk of infections and is often complicated by fever, which may be the only early clinical sign of life-threatening bacterial infections. Understanding local epidemiological trends is critical to guiding effective infection control and antibiotic strategies, especially in resource-limited settings. In Iraq, where local epidemiological data remain scarce, this study provides urgently needed insights to inform infection control in oncology care. This study aimed to evaluate the incidence of fever and patterns of bacterial infections among neutropenic cancer patients in Iraq. A prospective cross-sectional study was conducted on 98 adult neutropenic cancer patients admitted to the Oncology Teaching Hospital, Almal National Hospital for Cancer Treatment, and Hematology and Transplant Center (HTC). Data on age, gender, cancer type, neutropenia severity, fever presence, and microbiological culture results were extracted and analyzed descriptively. The majority of the patients were female (68.4%) and over 50 years of age (75.5%). Hematological malignancies accounted for 81% of all cases. The most prevalent form was moderate neutropenia (68.4%). Fever developed in 58.2% of patients, and among these, 77.2% had positive bacterial cultures. Gram-negative organisms were predominant, with Escherichia coli (33.3%) and Klebsiella pneumoniae (29.8%) being the most frequently isolated pathogens. Neutropenia is highly prevalent among Iraqi cancer patients with hematological malignancies and is frequently accompanied by fever and Gram-negative bacterial infections. These findings highlight the need for routine microbiological surveillance, timely diagnosis, and context-specific empirical antibiotic protocols. Strengthening infection prevention strategies and updating treatment guidelines in oncology centers are essential to reducing infection-related morbidity in this vulnerable population.