A multi-centre prospective study of febrile neutropenia in Norway: microbiological findings and antimicrobial susceptibility.
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.
Sigurdardottir
Katrin
K
Institute of Medicine, Haukeland University Hospital, Bergen, Norway. katrin.sigurdardottir@helse-bergen.no
Digranes
Asbjørn
A
Harthug
Stig
S
Nesthus
Ingerid
I
Tangen
Jon-Magnus
JM
Dybdahl
Britt
B
Meyer
Peter
P
Hopen
Gunnar
G
Løkeland
Turid
T
Grøttum
Kjell
K
Vie
Wenche
W
Langeland
Nina
N
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
D000900:Anti-Bacterial Agents