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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/18409

Title: Long-term epidemiology of bacterial susceptibility profiles in adults suffering from febrile neutropenia with hematological malignancy after antibiotic change: a single centre prospective study with 15 years of follow-up
Authors: Mebis, Jeroen
Jansens, Hilde
Minalu, Girma
Molenberghs, Geert
Schroyens, W.
Gadisseur, Alain
Van de Velde, An L. R.
Vrelust, Inge
Goossens, Herman
Berneman, Zwi N.
Issue Date: 2010
Citation: Infection and drug resistance, 3, p. 53-61
Abstract: Objective: The aim of this study was to investigate the epidemiology and antibiotic susceptibility profiles of isolated bacterial organisms in relation to empiric treatment of neutropenic fever over a 15-year period. Methods: All patients with or at risk for febrile neutropenia and treated in the hematology ward of the Antwerp University Hospital during 1994–2008 were prospectively included. Skin, blood, and urine cultures were taken. Oral quinolone prophylaxis was started in patients with neutropenia without fever. Empiric starting therapy consisted of amikacin in combination with cefepime. Results: A total of 3624 bacteria were isolated. The most common pathogens were coagulasenegative Staphylococci (46%), followed by Escherichia coli (25%), Enterobacteriaceae (15.6%), Staphylococcus aureus (7.2%), and Pseudomonas aeruginosa (3.8%). The balance between Gram-positive and Gram-negative bacteria remained stable, with a majority of Gram-positive bacteria. A shift from oxacillin-sensitive to oxacillin-resistant coagulase-negative Staphylococci was observed. Regarding susceptibility patterns, no vancomycin resistance was detected in coagulase-negative Staphylococci or in S. aureus. The E. coli susceptibility rates remained stable. However, 66% of bloodstream infections were ciprofloxacin-resistant. A reduced susceptibility of P. aeruginosa strains to meropenem was noticed. Conclusions: Improvement in antibiotic susceptibility of inducible Enterobacteriaceae following a switch of empiric antibiotic therapy was maintained 15 years after starting the latter treatment. Further improvement in antibiotic susceptibility of these bacteria to ceftazidime was observed, but continuous vigilance is warranted.
Notes: Correspondence: J Mebis Medical Oncology, Limburgs Oncologisch Centrum, Jessa Ziekenhuis, Stadsomvaart 11, 3500 Hasselt, Belgium Tel +32 011 309 960 Fax +32 011 309 968 Email jeroen.mebis@jessazh.be
URI: http://hdl.handle.net/1942/18409
ISSN: 1178-6973
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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