Clinical characteristics and antimicrobial susceptibilities of viridans streptococcal bacteremia during febrile neutropenia in patients with hematologic malignancies: a comparison between adults and children
نویسندگان
چکیده
BACKGROUND This study was performed to compare the clinical characteristics and antibiotic susceptibilities of viridans streptococcal bacteremia (VSB) between febrile neutropenic adults and children with hematologic malignancies. METHODS The consecutive medical records of neutropenic patients with hematologic malignancies who were admitted to the Catholic Blood and Marrow Transplantation Center between April 2009 and July 2012, and who were subsequently diagnosed with VSB were reviewed retrospectively. A comparison was made between the clinical and laboratory characteristics of adults and pediatric patients and also between patients with cefepime susceptible or not susceptible VSB. RESULTS A total of 202 episodes (141 in adults, 61 in children) of VSB were identified. Among them, 26 (12.9%) cases had severe complications including four (2.0%) cases of death attributable to VSB. For antibacterial prophylaxis, most adults received ciprofloxacin (97.1%), but children more frequently received trimethoprim/sulfamethoxazole (86.9%). Oral mucositis (p = 0.005) and abdominal pain (p = 0.001) were found more frequently in adults, and cough was found more frequently in children (p = 0.004). The occurrence rates of severe complications and death attributable to VSB were not significantly different between adults and children. Susceptibility rate to cefepime was significantly higher in adults than children (85.7% vs. 66.1%, p = 0.002). However, in multivariate analysis, cefepime susceptibility had no impact on clinical outcome. CONCLUSIONS There was no significant difference in clinical outcome between adults and children with VSB despite a difference in cefepime susceptibility. Hence, different antibiotic treatment strategies may not be necessary.
منابع مشابه
Author's response to reviews Title: Clinical Characteristics and Antimicrobial Susceptibilities of viridans Streptococcal Bacteremia during Febrile Neutropenia in Patients with Hematologic Malignancies: A Comparison between Adults and Children Authors:
متن کامل
Viridans Group Streptococcal Infections in Children After Chemotherapy or Stem Cell Transplantation: A 10-year Review From a Tertiary Pediatric Hospital.
Viridans Group Streptococci (VGS) are associated with high mortality rates in febrile neutropenia; yet there are no recent European pediatric studies to inform antimicrobial therapy. The aim of this study was to describe the characteristics, outcome, and resistance patterns of children with VGS bacteremia (VGSB) undergoing treatment of malignancy or hematopoietic stem cell transplant. Patients ...
متن کاملMolecular relationships and antimicrobial susceptibilities of viridans group streptococci isolated from blood of neutropenic cancer patients.
From January 1995 to May 1998, 57 episodes of bacteremia due to viridans group streptococci were identified in 50 febrile neutropenic patients with hematologic malignancies. Four patients experienced two separate episodes of streptococcal bacteremia, and one patient had four separate episodes of streptococcal bacteremia. Strains were identified to species level as Streptococcus mitis (n = 37), ...
متن کاملAntibiotic resistance status and its costs in hematological patients: A two-year analysis
Background: Most frequently, empirical antibiotic therapy is immediately administered for patients with febrile neutropenia (FN). In this study, its aim was to assess the antibiotic resistance status and the cost of antibacterial agents in FN patients associated with hematological malignancies. Methods: The cost of antibacterial agents used in FN episodes in patients with hematologic neoplasms ...
متن کاملManagement of Febrile Neutropenia in Children with Cancer; a Practical Guide to Diagnosis and Treatment
This study aimed to provide an evidence-based guideline for the clinical management of febrile neutropenia in children with cancer. In this narrative review, the most recently published sources of information on febrile neutropenia consisting of textbooks and articles, have been reviewed. We focused on the more recent data about diagnosis, treatment and management in children through the use o...
متن کامل