title: Staphylococcal bacteremia in cancer patients: risk factors and outcome in 134 episodes prior to and after introduction of quinolones into infection prevention in neutropenia.
abstract: A total of 134 episodes of staphylococcal bacteremia (SBE) appearing among 9987 admissions, and 979 episodes of bacteremia in cancer patients within 5 years, were analyzed for risk factors, clinical course and outcome; 64 were monomicrobial and 70 polymicrobial. The most frequent risk factors were acute leukemia, catheter insertion, long-lasting neutropenia, and prior prophylaxis with quinolones. There was no significant difference between polymicrobial and monomicrobial SBE in risk factors. The two groups differed only in the source of bacteremia (gastrointestinal and respiratory-tract infections were more common in monomicrobial SBE) and etiology-Staphylococcus aureus appeared more frequently in monomicrobial than in polymicrobial bacteremia (20.3% compared to 4.3%, P < 0.05). More complications (14.3%) such as abscesses, endocarditis, etc. appeared in the group of polymicrobial SBE (P < 0.05). No difference was observed in clinical course and outcome between monomicrobial and polymicrobial SBE. The incidence of SBE has increased since 1991, when quinolones were first used in prophylaxis in afebrile neutropenia at our center; however, the infection-associated mortality in monomicrobial SBE was low (4.3%).
authors.affiliation: Department of Medicine, University of Trnava, Slovak Republic.
authors.forename: E
authors.initials: E
authors.lastname: Kukuckova
authors.forename: S
authors.initials: S
authors.lastname: Spanik
authors.forename: I
authors.initials: I
authors.lastname: Ilavska
authors.forename: L
authors.initials: L
authors.lastname: Helpianska
authors.forename: E
authors.initials: E
authors.lastname: Oravcova
authors.forename: J
authors.initials: J
authors.lastname: Lacka
authors.forename: I
authors.initials: I
authors.lastname: Krupova
authors.forename: S
authors.initials: S
authors.lastname: Grausova
authors.forename: P
authors.initials: P
authors.lastname: Koren
authors.forename: I
authors.initials: I
authors.lastname: Bezakova
authors.forename: E
authors.initials: E
authors.lastname: Grey
authors.forename: M
authors.initials: M
authors.lastname: Balaz
authors.forename: M
authors.initials: M
authors.lastname: Studena
authors.forename: A
authors.initials: A
authors.lastname: Kunova
authors.forename: K
authors.initials: K
authors.lastname: Torfs
authors.forename: J
authors.initials: J
authors.lastname: Trupl
authors.forename: S
authors.initials: S
authors.lastname: Korec
authors.forename: K
authors.initials: K
authors.lastname: Stopkova
authors.forename: V
authors.initials: V
authors.lastname: Krcmery
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D018154:Slovakia / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D024841:Fluoroquinolones