Staphylococcus aureus bacteremia in patients with hematological malignancies and/or agranulocytosis.
A total of 6,253 cases of Staphylococcus aureus bacteremia, including 274 (4.4%) endocarditis cases, were registered in Denmark in the period 1975-1984. Patients with hematological malignancies and/or agranulocytosis accounted for 479 of the bacteremia cases. The incidence of endocarditis in this group of patients was only 0.4% as compared to 4.7% in other patients with staphylococcal bacteremia (p less than 0.01). The lower incidence of endocarditis complicating bacteremia in these patients may justify a shorter course of therapy than usually recommended for suspected endocarditis. Patients with hematological malignancies and other patients with agranulocytosis had a higher mortality (49 and 46%, respectively) than other patients with S. aureus bacteremia (33%). The highest mortality was found in patients with multiple myeloma (71%, p less than 0.01), the lowest in patients with acute lymphocytic leukemia (28%, p less than 0.01). The higher mortality in these patients may indicate that empiric antibiotic regimens in granulocytopenic patients should include a specific anti-staphylococcal agent.
D000368:Aged; D000380:Agranulocytosis / Q000382:microbiology*; D004697:Endocarditis, Bacterial / Q000209:etiology; D005260:Female; D006801:Humans; D007938:Leukemia / Q000382:microbiology*; D008223:Lymphoma / Q000382:microbiology*; D008297:Male; D011087:Polycythemia Vera / Q000382:microbiology; D018805:Sepsis / Q000209:etiology* / Q000276:immunology / Q000401:mortality; D013203:Staphylococcal Infections / Q000209:etiology* / Q000276:immunology / Q000401:mortality; D008258:Waldenstrom Macroglobulinemia / Q000382:microbiology