Changes in the Incidence and Etiological Patterns of Bacteremia Associated with Acute Leukemia over a 25-Year Period.

Abstract

During the 25-year period from 1972-1996, 360 episodes ofbacteremia occurred in 248 (45%) of a total of 548 patients with acute leukemia on our hematology ward, with the rate of occurrence remaining almost unchanged. Patients with acute nonlymphocytic leukemia, however, had a significant decrease in the incidence of bacteremia during the last 5-year period. Gram-negative bacilli decreased in relative frequency from 64% for the first 15-year period to 40% for the last 5-year period, whereas gram-positive cocci increased from 24%to 51%. Escherichia coli and Enterobacter cloacae somewhat decreased in frequency, whereascoagulase-negative staphylococci and streptococci had considerable increases. In contrast, Pseudomonasaeruginosa was isolated at a relatively constant frequency, forming one of the top two pathogens throughout the study period. Despite the shift toward gram-positive cocci, therefore, P. aeruginosa remains a key organism in considering the initial empiric antibiotic regimen and infection prevention during neutropenia.

Impact of bloodstream infections on outcome and the influence of prophylactic oral antibiotic regimens in allogeneic hematopoietic SCT recipients

“…[1][2][3][4][5]40,55,59 Literature from other countries in general showed a trend shifting from GNB predominance to Gram-positive bacteria predominance. 3,[60][61][62][63] Changing trends of nosocomial BSIs pathogens over time, variations among institutional or geographic epidemiology of nosocomial BSIs, and variations of prophylactic antibiotics applied may account for this discrepancy.…”

Increase in Antibiotic-Resistant Gram-Negative Bacterial Infections in Febrile Neutropenic Children

“…Because empirical antibiotic therapy targeting the common and virulent pathogens is important for febrile neutropenic patients [ 1 ], continuous surveillance of the causative bacteria of bacteremia in febrile neutropenic patients should be conducted. In the 1960s and 1970s, most cases of bacteremia in febrile neutropenic patients were caused by Gram-negative bacilli, such as Escherichia coli , Klebsiella pneumoniae , and Pseudomonas aeruginosa [ 2 3 ]. However, bacteremia caused by Gram-positive cocci increased in the 1980s with the introduction of fluoroquinolone prophylaxis, widespread use of central venous catheters, and use of potent anticancer chemotherapy causing severe mucositis [ 2 3 4 ].…”

“…In the 1960s and 1970s, most cases of bacteremia in febrile neutropenic patients were caused by Gram-negative bacilli, such as Escherichia coli , Klebsiella pneumoniae , and Pseudomonas aeruginosa [ 2 3 ]. However, bacteremia caused by Gram-positive cocci increased in the 1980s with the introduction of fluoroquinolone prophylaxis, widespread use of central venous catheters, and use of potent anticancer chemotherapy causing severe mucositis [ 2 3 4 ]. Such a change was also observed in our hospital: 57.4% of bacteremia cases in febrile neutropenic children were caused by Gram-positive bacteria (GPB) in 2009 [ 5 ].…”

Pseudomonas aeruginosa inhibits in-vitro Candida biofilm development

“…United States Cystic Fibrosis Foundation Patients Registry (2004), has stated that 57.3% of all reported respiratory cultures contained P. aeruginosa indicating its important role in causing chronic and recurrent infections in cystic fibrotic patients [ 14 ]. Lee et al [ 15 ] have demonstrated that P. aeruginosa is the most commonly identified cause of septicemia in primary immunodeficiency and some 20% of bacteriaemia in acute leukemic patients [ 16 , 17 ]. Incidence of P. aeruginosa bacteriaemias in HIV affected patients is approximately 10 times higher than that of the normal population [ 18 ].…”