title: Bacteremia and fungemia occurring during antimicrobial prophylaxis with ofloxacin in cancer patients: risk factors, etiology and outcome.
abstract: 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.
authors.affiliation: Dept. of Medicine, University of Trnava, Bratislava, Slovak Republic.
authors.forename: S
authors.initials: S
authors.lastname: Spanik
authors.forename: J
authors.initials: J
authors.lastname: Trupl
authors.forename: I
authors.initials: I
authors.lastname: Ilavska
authors.forename: L
authors.initials: L
authors.lastname: Helpianska
authors.forename: L
authors.initials: L
authors.lastname: Drgona
authors.forename: A
authors.initials: A
authors.lastname: Demitrovicova
authors.forename: E
authors.initials: E
authors.lastname: Kukuckova
authors.forename: M
authors.initials: M
authors.lastname: Studena
authors.forename: P
authors.initials: P
authors.lastname: Pichna
authors.forename: E
authors.initials: E
authors.lastname: Oravcova
authors.forename: V
authors.initials: V
authors.lastname: Rusnakova
authors.forename: P
authors.initials: P
authors.lastname: Koren
authors.forename: J
authors.initials: J
authors.lastname: Lacka
authors.forename: V
authors.initials: V
authors.lastname: Krcmery
mesh_terms: 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
chemical_list: D015242:Ofloxacin