Bacteremia and fungemia occurring during antimicrobial prophylaxis with ofloxacin in cancer patients: risk factors, etiology and outcome.
The authors analyzed 27 breakthrough bacteremias occurring during ofloxacin prophylaxis in afebrile neutropenia over 7 years in 9989 admissions and 979 bacteremic and fungemic episodes in a National Cancer Center in Bratislava, Slovak Republic. The most frequently isolated organisms in breakthrough bacteremias were gram-positive (71.3%), mainly coagulase-negative staphylococci (41.3%), enterococci (9.2%) and Corynebacteria (9.2%), followed by gram-negative rods-Pseudomonas aeruginosa (13.2%) and Stenotrophomonas maltophilia (9.2%). The outcome of breakthrough bacteremias during ofloxacin prophylaxis was not associated with the underlying disease, neutropenia, catheter insertion or resistance, but only with multiple risk factors. A higher failure rate was observed in those patients having a catheter infected with a resistant organism and during neutropenia. No patients with Hickman catheter were included in the study. Patients with mixed breakthrough bacteremia due to gram-negative and gram-positive organisms had higher failure rates than those with monomicrobial bacteremia. Catheter extraction and rapid institution of intravenous antibiotics in combination should be administered in breakthrough bacteremia.
Spanik
S
S
Dept. of Medicine, University of Trnava, Bratislava, Slovak Republic.
Trupl
J
J
Ilavska
I
I
Helpianska
L
L
Drgona
L
L
Demitrovicova
A
A
Kukuckova
E
E
Studena
M
M
Pichna
P
P
Oravcova
E
E
Rusnakova
V
V
Koren
P
P
Lacka
J
J
Krcmery
V
V
D016470:Bacteremia / Q000453:epidemiology / Q000517:prevention & control*; D004196:Disease Outbreaks; D016469:Fungemia / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008826:Microbial Sensitivity Tests; D009369:Neoplasms / Q000150:complications*; D015242:Ofloxacin / Q000627:therapeutic use*; D009894:Opportunistic Infections / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D018154:Slovakia / Q000453:epidemiology; D016896:Treatment Outcome
D015242:Ofloxacin