Bacteraemia in patients with haematological malignancies
Abstract number: 902_p1400
To investigate the incidence, pathogens and antibiotic resistance of isolates from bacteraemic patients of the Haematology unit over a 3-year period (20012003).
A total of 193 patients presented one ore more episodes of bacteraemia during a 3-year period. The identity and MIC determination of isolates were performed by the Vitek II system (bioMerieux, France), conventional methods and the Etest method (Solna, Sweden).
Bacteraemia was microbiologically documented in 193/321 (60.1%) cases. Polymicrobial bacteraemia was observed in 22/193 cases (11.4%). A total of 265 strains had been isolated, among which 163/265 (61.5%) were Gram-positive bacteria, 88/265 (33.2%) Gram-negative bacteria, 10/265 (3.8%) fungi and four of 265 (1.5%) anaerobes. Of our Gram-positive isolates 23/163 (14.1%) were infrequent in earlier years: Listeria monocytogenes six of 163 (2.3%), Corynebacterium spp 14/163 (8.6%), Streptococcus viridans two of 163 (1.3%) and Leuconostoc spp one of 163 (0.6%). Staphylococci coagulase negative were the most common pathogens, 69/265 (36.2%). Of them, 66/96 (68.7%) were methicillin-resistant and six of 96 (6.25%) were identified as glycopeptide (teicoplanin)-intermediate Staphylococcus species (GISS). Enterococcus faecium was more common than Enterococcus faecalis (25 strains vs. six strains) and 18/25 (72%) of them were resistant to glycopeptides (vanA). Klebsiella pneumoniae and E. coli strains produced ESBLs in 15/17 (88.3%) and five of 20 (25%) cases, respectively. One strain Ps. aeruginosa was resistant to all tested agents.
Gram-positive organisms were the predominant pathogens in our patients, especially the coagulase-negative staphylococci, followed by Gram-negative bacteria and fungi. Methicillin resistant Staphylococcus species (MRSS) accounted for approximately 68.7% and teicoplanin resistant Staphylococcus species (GISS) for 6.25% of coagulase negative Staphylococcal infections. Enterococcus faecium, the most common Enterococcus species, was 72% resistant to glucopeptides (vanA). Ongoing cooperation between haematologists and microbiologists is important to detect the distribution of pathogens, which can be used to design policies for empirical antibiotic therapy and infection control measures."
|Session name:||XXIst ISTH Congress|
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