Prospective study of 288 episodes of bacteremia in neutropenic cancer patients in a single institution

Abstract

Trends in causative organisms and sources of infection were studied in a series of 288 episodes of bacteremia in neutropenic cancer patients observed in a single institution from 1986 to 1993. The incidence of bacteremia increased significantly from 20 episodes per 1000 admissions in 1986 to 50 episodes per 1000 admissions in 1993 (p = 0.00001). Over the study period, a continuous increment in gram-positive bacteremia, which reached 81% of episodes in 1993 (p = 0.000001), was observed. Conversely, the incidence of gram-negative bacteremia remained stable. Coagulase-negative staphylococci and viridans group streptococci were the most commonly isolated pathogens. Bacteremia caused by coagulase-negative staphylococci increased from 3 episodes per 1000 admissions to 19 episodes per 1000 admissions (p = 0.0001), and viridans group streptococci bacteremia increased from 0 episodes per 1000 admissions to 19 episodes per 1000 admissions (p = 0.000001). The upward trend in gram-positive bacteremia appeared to be related to a significant increase in both intravascular catheters (p = 0.003) and oral mucositis (p = 0.003) as sources of infection. Specific strategies to prevent chemotherapy-induced mucositis and catheter-related bacteremia merit further investigations.

A Population-Based Study of Bacterial Spectrum in Febrile Neutropenic Patients

“…Staphylococci and S. viridans were the most commonly isolated bacteria in this study (21). Moreover, in a multicentre study on febrile neutropenic patients in the USA Wisplinghoff et al (19) reported the outweigh of Gram-positive microorganisms as a cause of 62% and 76% of blood stream infections in 1995 and 2000 respectively, while only 22% and 14% of all blood stream infections originated from Gram-negative ones at the same time (19).…”

Bacteremia after hematopoietic stem cell transplantation: incidence and predictive value of surveillance cultures

“…A major aim of our study was to examine the ability of routine surveillance cultures to predict the causative agents of bacteremia, one of the most Table 2 Bacteremias and fungemias according to timing of hospitalization and delay after transplantation Streptococci 15 68 7 32 17 65 9 35 Coag-neg staphylococci 40 61 26 39 47 45 58 55 Other Gram-pos 8 57 6 43 6 32 13 68 Anaerobes 2 67 1 33 6 100 0 0 Gram-neg 25 52 23 48 36 44 45 56 Fungi 5 63 3 37 5 83 1 17 Total 95 59 66 41 117 48 126 52 frequent life-threatening infections in neutropenic patients. 9 Indeed, the mortality primarily or secondarily due to infections has been reported to reach 60% in some series of patients undergoing HSCT.…”

Bloodstream infections in neutropenic cancer patients: A practical update

“…[29][30][31] That shift was probably caused by widespread administration of FQs prophylaxis, the almost universal use of CVCs and by chemotherapy regimens associated with severe mucositis. 31 In fact, in 2000 GP bacteria accounted for 76% of all BSIs in cancer patients in the United States. 29 However, this tendency has reversed again, with GN bacteria becoming more frequent than GP in many centers.…”