title: Morbidity and mortality attributable to Rothia bacteremia in neutropenic and nonneutropenic patients.
abstract: Rothia spp. are increasingly being recognized as emerging opportunistic pathogens associated with serious infections in immune-compromised hosts. Risk factors include neutropenia, hematologic malignancies, prosthetic devices, and intravascular catheters. We describe 29 patients at our institute from 2006 to 2014 with positive blood cultures for Rothia spp. Neutropenia was observed in 21/29 (72%) patients at the time of bacteremia, and 16/29 (61%) had leukemia. Neutropenic patients were less likely than nonneutropenic patients to have polymicrobial infection (24% versus 63%; P= 0.083) and were also more likely to have multiple positive blood cultures (76% versus 0%; P= 0.0003), indicating true infection. Sources of bacteremia included intravascular catheters, mucositis, and presumed gut translocation. A significant association was seen with steroid use (81% versus 13%; P= 0.0014) and fluoroquinolone use (86% versus 13%; P≤ 0.0001) preceding bacteremia in neutropenic patients. There was no difference between the 2 groups for admission to intensive care unit or mortality. One death was reported possibly due to Rothia infection.
authors.affiliation: Division of Infectious Disease, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: mabidi@outlook.com.
authors.forename: M Z
authors.initials: MZ
authors.lastname: Abidi
authors.affiliation: Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: N
authors.initials: N
authors.lastname: Ledeboer
authors.affiliation: Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: A
authors.initials: A
authors.lastname: Banerjee
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: P
authors.initials: P
authors.lastname: Hari
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D015897:Comorbidity; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology* / Q000209:etiology*; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008835:Micrococcaceae; D008875:Middle Aged; D009017:Morbidity; D009026:Mortality; D009503:Neutropenia / Q000150:complications*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents
keywords: Bacteremia; Neutropenia; Rothia mucilaginosa