TITLE

Epidemiology and Risk Factors for Gram-Positive Coccal Infections in Neutropenia: Toward a More Targeted Antibiotic Strategy

AUTHOR(S)
Cordonnier, Catherina; Buzyn, Agnes; Leverger, Guy; Herbrecht, Raou; Hunault, Mathilde; Leclercq, Roland; Bastuji-Garin, Sylvie
PUB. DATE
January 2003
SOURCE
Clinical Infectious Diseases;1/15/2003, Vol. 36 Issue 2, p149
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The objective of this study was to evaluate the risk of acquiring gram-positive coccal infections in febrile neutropenic patients and to develop risk indexes for gram-positive and streptococcal infections. This prospective, multicenter study included 513 patients. The prevalence of gram-positive coccal infections was 21% (14% were staphylococcal infections and 7.8% were streptococcal infections). The mortality rate during the month after study enrollment was 5%. On multivariate analysis, the occurrence of gram-positive coccal infections was significantly associated with receipt of high-dose cytarabine therapy, proton pump inhibitors, and gut decontamination with colimycin without glycopeptides and presence of chills. Staphylococcal infection was significantly associated with use of nonabsorbable colimycin, and streptococcal infection was associated with diarrhea, use of nonabsorbable antifungals, receipt of high-dose cytarabine, and gut decontamination with colimycin. The relative risks for streptococcal infection were 2.9, 13.2, and 20.7 in the presence of 1, 2, and ≥3 parameters, respectively. Risk factors for staphylococcal and streptococcal infections differ among neutropenic patients. A simple scoring system for predicting streptococcal infection is proposed.
ACCESSION #
8875014

 

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