Changes in the Etiology of Bacteremia in Febrile Neutropenic Patients and the Susceptibilities of the Currently Isolated Pathogens

Ramphal, Reuben
July 2004
Clinical Infectious Diseases;7/15/2004 Supplement 1, Vol. 39, pS25
Academic Journal
The etiology of bacteremia in febrile neutropenic patients in the past few decades has shifted from gram-negative to gram-positive organisms. Potential reasons include the use of indwelling catheters, local environmental conditions, and the administration of specific antibiotic agents, especially as prophylaxis. Other factors may emerge from new studies, such as the categorization of febrile neutropenic patients into groups at low risk and at high risk of developing serious complications, continuing changes in resistance in the community, the use of antibiotic-coated catheters, and future changes in cytotoxic chemotherapy or antineoplastic therapy. In addition, there has been a drift in susceptibility patterns, with resistance issues seen in the general population of hospitalized patients now emerging in febrile neutropenic patients, as well as some issues specific to these patients. These changes affect empirical therapy as it was practiced a decade ago. Among the most commonly used agents, cefepime and carbapenems continue to show the highest rates of in vitro susceptibility, providing coverage against most gram-positive and gram-negative organisms and reducing the need for glycopeptides. Older agents continue to show degradation of their effectiveness. Among Pseudomonas aeruginosa strains, susceptibility to all agents continues to decline.


Related Articles

  • A Woman with a Lesion on Her Finger and Bacteremia. Mackowiak, Philip // Clinical Infectious Diseases;10/1/2005, Vol. 41 Issue 7, p1057 

    The article focuses on the case of a woman with a lesion on her finger and bacteremia. The cutaneous injury suggested a zoonosis, and blood cultures grew a pleomorphic, nonsporulating, gram-positive bacillus identified as E. rhusiopathiae. E. rhusiopathiae is recognized as a common commensal or...

  • Sarcina ventriculi in blood: the first documented report since 1872. Tuuminen, Tamara; Suomala, Päivi; Vuorinen, Sakari // BMC Infectious Diseases;2013, Vol. 13 Issue 1, p1 

    Background: In 1872, in British Medical Journal (BMJ) Dr. David Ferrier published that Sarcina ventriculi (Goodsir) constantly occurred in the blood of man and the lower animals. His observation was based on bleeding experiments, incubation of blood at 100°F (37.8°C) and later examination....

  • Neither Single nor a Combination of Routine Laboratory Parameters can Discriminate between Gram-positive and Gram-negative Bacteremia. Ratzinger, Franz; Dedeyan, Michel; Rammerstorfer, Matthias; Perkmann, Thomas; Burgmann, Heinz; Makristathis, Athanasios; Dorffner, Georg; Loetsch, Felix; Blacky, Alexander; Ramharter, Michael // Scientific Reports;11/6/2015, p16008 

    Adequate early empiric antibiotic therapy is pivotal for the outcome of patients with bloodstream infections. In clinical practice the use of surrogate laboratory parameters is frequently proposed to predict underlying bacterial pathogens; however there is no clear evidence for this assumption....

  • MANAGEMENT OF CLOSTRIDIUM DIFFICILE INFECTION - MEDICAL OR SURGICAL? Fitzpatrick, F. // Surgeon (Edinburgh University Press);Dec2008, Vol. 6 Issue 6, p325 

    The article reports on the medical or surgical management of Clostridium difficile infection (CDI). The management of severe CDI calls for early surgical consultation and a joint medical and surgical approach, It is generally accepted that in severe infection, timely surgical management may...

  • Oritavancin: Mechanism of Action. Zhanel, George G.; Schweizer, Frank; Karlowsky, James A. // Clinical Infectious Diseases;2012 Supplement 3, Vol. 54, pS214 

    Oritavancin is a semisynthetic lipoglycopeptide analogue of vancomycin that contains the heptapeptide core common to all glycopeptides. It differs from vancomycin by the presence of a hydrophobic N-4-(4-chlorophenyl)benzyl (also referred to as 4é-chlorobiphenylmethyl) substituent on the...

  • Clinical Infections and Bloodstream Isolates Associated with Fever in Patients Undergoing Chemotherapy for Acute Myeloid Leukemia. Madani, L. A. // Infection;Dec2000, Vol. 28 Issue 6, p367 

    Background: Patients with acute myeloid leukemia (AML) are at high risk for infections. The aim of this study was to identify the sources of fever and the type of pathogens that cause bloodstream infection in patients with AML undergoing cytotoxic chemotherapy and antibiotic prophylaxis....

  • Functional synergy of α-helical antimicrobial peptides and traditional antibiotics against Gram-negative and Gram-positive bacteria in vitro and in vivo. Feng, Q.; Huang, Y.; Chen, M.; Li, G.; Chen, Y. // European Journal of Clinical Microbiology & Infectious Diseases;Jan2015, Vol. 34 Issue 1, p197 

    In this study, the antimicrobial activities based on the synergistic effects of traditional antibiotics (imipenem, cefepime, levofloxacin hydrochloride and vancomycin) and antimicrobial peptides (AMPs; PL-5, PL-31, PL-32, PL-18, PL-29 and PL-26), alone or in combination, against three...

  • Antimicrobial activity of selected South African medicinal plants. H. Nielsen, Trine R.; Kuete, Victor; Jäger, Anna K.; Marion Meyer, Jacobus J.; Lall, Namrita // BMC Complementary & Alternative Medicine;2012, Vol. 12 Issue 1, p74 

    Background: Nearly 3,000 plant species are used as medicines in South Africa, with approximately 350 species forming the most commonly traded and used medicinal plants. In the present study, twelve South African medicinal plants were selected and tested for their antimicrobial activities against...

  • Use of daptomycin in complicated cases of infective endocarditis. Das, I.; Saluja, T.; Steeds, R. // European Journal of Clinical Microbiology & Infectious Diseases;Jun2011, Vol. 30 Issue 6, p807 

    Infective endocarditis (IE) is a serious form of infection with a high mortality. Medical management can be a challenge because of organ dysfunction, lack of clinical response or allergy to the recommended antibiotics. Daptomycin is a lipopeptide antibiotic with a potent bactericidal activity...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics