Bacteremia due to viridans streptococcus in neutropenic patients with cancer: clinical spectrum and risk factors.

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Serval ID
serval:BIB_6D07956708C5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Bacteremia due to viridans streptococcus in neutropenic patients with cancer: clinical spectrum and risk factors.
Journal
Clinical Infectious Diseases
Author(s)
Bochud P.Y., Eggiman P., Calandra T., Van Melle G., Saghafi L., Francioli P.
ISSN
1058-4838
Publication state
Published
Issued date
01/1994
Peer-reviewed
Oui
Volume
18
Number
1
Pages
25-31
Language
english
Abstract
Between 1988 and 1991, 26 episodes of bacteremia due to viridans streptococci occurred in 25 neutropenic patients undergoing intensive chemotherapy for hematologic malignancies. Complications related to the bacteremia were observed in 10 episodes: unilateral pulmonary infiltrates (4), acute respiratory distress syndrome (ARDS) (4), hypotension (3), and endocarditis (2). All patients with ARDS had received high doses of cytosine arabinoside and had bacteremia due to Streptococcus mitis. Death occurred in three patients (12%) but was possibly related to bacteremia in only one case. Case patients who had received prophylaxis with quinolones were compared with matched control patients who received similar prophylaxis but who did not have bacteremia due to viridans streptococci. Multivariate analysis of predisposing factors showed that high doses of cytosine arabinoside (P = .01), the presence of mucositis (P = .02), and the absence of previous therapy with parenteral antibiotics (P = .01) were independent risk factors for the development of viridans streptococcal bacteremia. Of 259 patients who had received quinolone prophylaxis during the study period, 22 (8.5%) developed an episode of viridans streptococcal bacteremia as compared with three episodes (3.7%) in 82 patients who had received a quinolone and penicillin (P = .07). However, the latter three episodes were caused by strains with decreased susceptibility to penicillin, thus suggesting that resistance to penicillin might limit the use of this antibiotic as a prophylactic agent in the future.
Keywords
4-Quinolones, Adolescent, Adult, Aged, Anti-Infective Agents, Bacteremia, Case-Control Studies, Female, Hodgkin Disease, Humans, Leukemia, Myeloid, Acute, Lymphoma, Non-Hodgkin, Male, Middle Aged, Multiple Myeloma, Neutropenia, Penicillins, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Risk Factors, Streptococcal Infections, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
05/02/2008 6:39
Last modification date
14/02/2022 7:55
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