Document Detail


Effects on spectrum and susceptibility patterns of isolates causing bloodstream infection by restriction of fluoroquinolone prophylaxis in a hematology-oncology unit.
MedLine Citation:
PMID:  18058141     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The emergence of fluoroquinolone-resistant gram-negative organisms has been demonstrated in patients given fluoroquinolone prophylaxis. To prevent increases in resistant bacteria, we restricted prophylactic use of fluoroquinolones. The spectrum and susceptibility patterns of isolates causing bloodstream infection (BSI) were assessed in patients receiving chemotherapy during periods of routine prophylaxis (period A: October 2001 to May 2003) and restricted prophylaxis (period B: June 2003 to January 2005). The total number of patients receiving chemotherapy was 442 during period A and 365 during period B. No significant differences were seen between periods with respect to patient characteristics. BSI was identified in 42 patients (44 episodes) during period A and 69 patients (74 episodes) during period B. Incidence of BSI increased significantly from 10.0% (44/442) during period A to 20.3% (74/365) during period B (P < 0.0001). Rate of Enterobacteriaceae BSI increased significantly, from 2.0% (9/442) during period A to 8.2% (30/365) during period B (P < 0.0001). For all BSI episodes, the proportion of BSI with gram-positive cocci decreased from 63.6% (28/44) during period A to 44.6% (33/74) during period B (P = 0.045), while the proportion of BSI with Enterobacteriaceae increased from 20.5% (9/44) to 40.5% (30/74) (P < 0.0001). The proportion of fluoroquinolone-resistant Enterobacteriaceae BSI for all Enterobacteriaceae BSI decreased from 75% (9/12) during period A to 17% (5/30) during period B (P = 0.0078). Restriction of fluoroquinolone prophylaxis affects the etiology of BSI and reduces the proportion of drug-resistant organisms.
Authors:
T Saito; S Yoshioka; Y Iinuma; S Takakura; N Fujihara; T Ichinohe; T Ishikawa; T Uchiyama; S Ichiyama
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology     Volume:  27     ISSN:  0934-9723     ISO Abbreviation:  Eur. J. Clin. Microbiol. Infect. Dis.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-14     Completed Date:  2008-06-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804297     Medline TA:  Eur J Clin Microbiol Infect Dis     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  209-16     Citation Subset:  IM    
Affiliation:
Department of Infection Control and Prevention, Kyoto University Hospital, 54 Kawahara-cho, Shougoin, Sakyo-ku, Kyoto 606-8507, Japan. saitota@kuhp.kyoto-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Antibiotic Prophylaxis*
Bacteremia / epidemiology,  microbiology*
Bacteria / classification*,  isolation & purification*
Cross Infection / epidemiology,  microbiology*
Enterobacteriaceae Infections / epidemiology,  microbiology
Female
Fluoroquinolones / therapeutic use*
Gram-Positive Bacterial Infections / epidemiology,  microbiology
Humans
Incidence
Male
Middle Aged
Chemical
Reg. No./Substance:
0/Fluoroquinolones

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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