title: A multi-centre prospective study of febrile neutropenia in Norway: microbiological findings and antimicrobial susceptibility.
abstract: The urgent need to treat presumptive bacterial or fungal infections in neutropenic patients has meant that initial therapy is empiric and based on the pathogens most likely to be responsible, and drug resistance. The traditional empirical treatment in Norway has been penicillin G and an aminoglycoside, and this combination has been criticized over recent y. We wished to analyse the microbiological spectrum and susceptibility patterns of pathogens causing bacteraemia in febrile neutropenic patients. This was a prospective multicentre study. During the study period of 2 y, a total of 282 episodes of fever involving 243 neutropenic patients was observed. In 34% of episodes bacteraemia was documented. Overall, 40% of the episodes were caused by Gram-positive organisms, 41% by Gram-negative organisms and 19% were polymicrobial. The most frequently isolated bacteria were Escherichia coli (25.6%), a- and non-haemolytic streptococci (15.6%), coagulase-negative staphylococci (12.4%) and Klebsiella spp. (7.4%). None of the Gram-negative isolates was resistant to gentamicin, meropenem, ceftazidime or ciprofloxacin. Only 5 coagulase-negative staphylococci isolates were resistant to both penicillin G and aminoglycoside. The overall mortality rate was 7%, and 1.2% due to confirmed bacteraemic infection.
authors: Institute of Medicine, Haukeland University Hospital, Bergen, Norway. katrin.sigurdardottir@helse-bergen.no
authors: Katrin
authors: K
authors: Sigurdardottir
authors: Asbjørn
authors: A
authors: Digranes
authors: Stig
authors: S
authors: Harthug
authors: Ingerid
authors: I
authors: Nesthus
authors: Jon-Magnus
authors: JM
authors: Tangen
authors: Britt
authors: B
authors: Dybdahl
authors: Peter
authors: P
authors: Meyer
authors: Gunnar
authors: G
authors: Hopen
authors: Turid
authors: T
authors: Løkeland
authors: Kjell
authors: K
authors: Grøttum
authors: Wenche
authors: W
authors: Vie
authors: Nina
authors: N
authors: Langeland
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000382:microbiology*; D001419:Bacteria / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D024881:Drug Resistance, Bacterial; D005260:Female; D005334:Fever / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000453:epidemiology* / Q000382:microbiology*; D009664:Norway / Q000453:epidemiology; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents