Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-28T15:13:56.988Z Has data issue: false hasContentIssue false
  • English
  • Français

Predominance of Gram-Positive Microorganisms as a Cause of Septicemia in Patients with Hematological Malignancies

Published online by Cambridge University Press:  02 January 2015

M. Rubio ,
L. Palau ,
J. Romero Vivas ,
E. del Potro ,
J. Diaz-Mediavilla ,
A. Alvarez ,
R. Martinez  and
J.J. Picazo
M. Rubio
Affiliation:
Department of Microbiology, Hospital Universitario San Carlos, Madrid, Spain
L. Palau
Affiliation:
Department of Microbiology, Hospital Universitario San Carlos, Madrid, Spain
J. Romero Vivas*
Affiliation:
Department of Microbiology, Hospital Universitario San Carlos, Madrid, Spain
E. del Potro
Affiliation:
Department of Hematology, Hospital Universitario San Carlos, Madrid, Spain
J. Diaz-Mediavilla
Affiliation:
Department of Hematology, Hospital Universitario San Carlos, Madrid, Spain
A. Alvarez
Affiliation:
Department of Hematology, Hospital Universitario San Carlos, Madrid, Spain
R. Martinez
Affiliation:
Department of Hematology, Hospital Universitario San Carlos, Madrid, Spain
J.J. Picazo
Affiliation:
Department of Microbiology, Hospital Universitario San Carlos, Madrid, Spain
*
Departamento de Microbiologia, Hospital Universitario San Carlos, Pza de Cristo Rey s/n, 28040 Madrid, Spain
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To ascertain the etiology and outcome of episodes of bacteremia and fungemia over a three-year period (1990-1992) in patients with hematological malignancies.

Design:

Retrospective study.

Setting:

Hematology service of a 1,500-bed Spanish university hospital.

Results:

Of a total of 178 episodes of significant bacteremia or fungemia in 101 patients, 53% affected patients with acute leukemia. Grampositive microorganisms were found to be the cause in 70% of the monomicrobial episodes. The most frequently isolated microorganism was coag-ulase-negative Staphylococcus (35%), followed by Staphylococcus aureus (11%). Most bloodstream infections occurred during an episode of neutropenia (59%). A total of 34 patients died during hospitalization; in 14, infection was the cause of death.

Conclusions:

A marked increase in the incidence of bacteremias caused by grampositive microorganisms has been observed in our hospital over the last 10 years, especially in patients with hematological malignancies. The mortality due to bacteremia is similar to that found by other authors in series of bacteremia in hematological patients, and we have not found significant differences in the mortality due to bacteremia between neutropenic and non-neutropenic patients.

Type
Brief Report
Information
Infection Control & Hospital Epidemiology , Volume 15 , Issue 2 , February 1994 , pp. 101 - 104
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Qi-Nan, W, Zhong-Da, Q. Infection in acute leukemia: an analysis of 433 episodes. Rev Infect Dis 1989;2(suppl 7): 1613–1620.CrossRefGoogle Scholar
2. Klastersky, J. Empiric treatment of infection during granulocytopenia: a comprehensive approach. Infection 1989;17:59–64.Google Scholar
3. EORTC International Antimicrobial Therapy Cooperative Group. Gram-positive septicemias in granulocytopenic cancer patients. Eur J Cancer 1990;26:569–574.Google Scholar
4. Pizzo, PA, Ladisch, S, Simon, RM, Gill, FA, Levine, AS. Increasing incidence of gram-positive sepsis in cancer patients. Med Fed Oncol 1978;5:241–244.CrossRefGoogle ScholarPubMed
5. Rubin, M, Hathom, JW, Marshall, D, Gress, J, Steinberg, SM, Pizzo, PA. Gram-positive infections and the use of vancomycin in 550 episodes of fever and neutropenia. Ann Intern Med 1988; 108:30–35.Google Scholar
6. Berenguer, J, Diaz-Mediavilla, J, Martinez, R, Fernandez, A, del Potro, E. Muñoz, I? Infective complications in neutropenic patients with malignant hemopathies. A prospective study of 279 episodes of neutropenia. Med Clin (Barcelona) 1990;95:481–485.Google Scholar
7. Elting, LS, Bodey, GP, Keefe, BH. Septicemia and shock syndrome due to viridans streptococci: a case-control study of predisposing factors. Clin Infect Dis 1992;14:1201–1207.Google Scholar
8. Wade, JC. Management of infection in patients with acute leukemia. In: Hematology/Oncology Clinics of North America. Philadelphia, PA: W.B. Saunders Co, 1993;7:293–315.Google Scholar
9. Bostrom, B, Weisdorf, D. Mucositis and streptococcal sepsis in bone marrow transplant recipients. Lancet 1984;1:1120–1121.Google Scholar
10. EORTC International Antimicrobial Therapy Cooperative Group. National Cancer Institute of Canada Clinical Trials Group Vancomycin added to empirical combination antibiotic therapy for fever in granulocytopenic cancer patients. J Infect Dis 1991;163:951–958.Google Scholar
11. Karp, JE, Dick, JD, Angelopulos, C, et al. Empiric use of vancomycin during prolonged treatment-induced granulocytopenia: randomized, double-blind, placebo-controlled clinical trial in patients with acute leukemia. Am I Med 1986;81:237–242.Google Scholar
12. Del Favero, A, Menichetti, R Guerciolini, R, et al. Prospective randomized clinical trial of teicoplanin for empiric combined antibiotic therapy in febrile granulocytopenic acute leukemia patients. Antimicrob Ag Chemother 1987;31:1126–1129.CrossRefGoogle ScholarPubMed
13. Ehni, WE Relier, LB, Ellison, RI III. Bacteremia in granulocytopenic patients in a tertiary care general hospital, Rev Infect Dis 1991;13:613–619.Google Scholar
14. Ispahani, P, Pearson, NJ, Greenwood, D. An analysis of community and hospital-acquired bacteraemia in a large teaching hospital in the United Kingdom. Q J Med 1987;63:427–440.Google Scholar