| Cefepime-resistant Gram-negative bacteremia in febrile neutropenic patients with hematological malignancies. | |
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MedLine Citation:
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PMID: 20471883 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVES: This study was performed to determine the local etiologic pattern of blood culture isolates and antibiotic resistance in febrile neutropenic patients with hematological malignancies. METHODS: A total of 142 blood culture isolates from febrile neutropenic patients admitted to our hematology unit were examined, particularly for the detection of cefepime resistance, because cefepime, a fourth-generation cephalosporin, has been used in our unit as initial therapy for febrile neutropenia. RESULTS: Among all isolates, 67 (47.2%) were Gram-positive bacteria, the majority of which were fully sensitive to vancomycin. Gram-negative bacteria accounted for 68 (47.9%) of the isolates. Cefepime resistance was seen in 24 (35.3%) of the Gram-negative isolates, and had significantly increased in 2007. The cefepime-resistant isolates primarily consisted of Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae. Approximately 60% of the cefepime-resistant isolates were extended-spectrum β-lactamase (ESBL)-producing organisms. Molecular analysis showed the predominant emergence of CTX-M types. Most of the cefepime-resistant isolates were resistant to third- and various fourth-generation cephalosporins, while having a high susceptibility to carbapenems, particularly meropenem. CONCLUSIONS: Cefepime resistance was often detected in the blood culture isolates from febrile neutropenic patients. This result suggests that therapeutic strategies for febrile neutropenia should be modified based on the local antibiotic resistance patterns. |
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Authors:
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Yong Chong; Hiroko Yakushiji; Yoshikiyo Ito; Tomohiko Kamimura |
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Publication Detail:
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Type: Journal Article Date: 2010-05-14 |
Journal Detail:
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Title: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases Volume: 14 Suppl 3 ISSN: 1878-3511 ISO Abbreviation: Int. J. Infect. Dis. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-10-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9610933 Medline TA: Int J Infect Dis Country: Canada |
Other Details:
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Languages: eng Pagination: e171-5 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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Department of Blood and Marrow Transplantation, Hara-Sanshin Hospital, 1-8 Taihaku-cho, Hakata-ku, Fukuoka, Japan. ychong@gj9.so-net.ne.jp |
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