title: Epidemiology and outcome of bacteraemia in neutropenic patients in a single institution from 1991-2012.
abstract: This study was part of a bloodstream infection surveillance programme that prospectively collected data on consecutive patients with bacteraemia in our institution from 1991 to 2012. We included 2092 bacteraemias in neutropenic patients. Shock and mortality accounted for 299 and 349 cases, respectively (14% and 17%). The main microorganisms isolated were coagulase-negative staphylococci (CoNS, 634, 30%), Escherichia coli (468, 22%) and Pseudomonas aeruginosa (235, 11%). During 2006-2012, there were 155 (27%) E. coli isolates; of these, 73% were fluoroquinolone resistant and 26% cefotaxime resistant. The independent risk factors for mortality were shock on presentation, rapidly fatal prognosis of underlying disease, corticosteroid use, and polymicrobial bacteraemia. Factors associated with lower mortality were the isolation of CoNS [odds ratio (OR) 0·38, 95% confidence interval (CI) 0·20-0·73, P = 0·004] and empirical therapy with amikacin (OR 0·50, 95% CI 0·29-0·88, P = 0·016). The progressive increase of Gram-negative microorganisms resistant to antibiotics influences the choice of empirical treatment in febrile neutropenia and in our experience, the addition of amikacin could be beneficial for such patients.
authors: Emergency Department and Infectious Diseases Unit, Hospital Clinic,University of Barcelona,Barcelona,Spain.
authors: M
authors: M
authors: Ortega
authors: Service of Clinical Microbiology,Barcelona Centre for International Health Research (CRESIB, Hospital Clinic, University of Barcelona),Barcelona,Spain.
authors: F
authors: F
authors: Marco
authors: Infectious Diseases Unit, Hospital Clinic,University of Barcelona,Barcelona,Spain.
authors: A
authors: A
authors: Soriano
authors: Service of Clinical Microbiology,Barcelona Centre for International Health Research (CRESIB, Hospital Clinic, University of Barcelona),Barcelona,Spain.
authors: M
authors: M
authors: Almela
authors: Infectious Diseases Unit, Hospital Clinic,University of Barcelona,Barcelona,Spain.
authors: J A
authors: JA
authors: Martínez
authors: Haematology Department, Hospital Clinic,University of Barcelona,Spain.
authors: M
authors: M
authors: Rovira
authors: Haematology Department, Hospital Clinic,University of Barcelona,Spain.
authors: J
authors: J
authors: Esteve
authors: Infectious Diseases Unit, Hospital Clinic,University of Barcelona,Barcelona,Spain.
authors: J
authors: J
authors: Mensa
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology / Q000401:mortality; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D024881:Drug Resistance, Bacterial; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications* / Q000453:epidemiology; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000209:etiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: outcome