Document Detail

Serious complications of bacteremia caused by Viridans streptococci in neutropenic patients with cancer.
MedLine Citation:
PMID:  11073739     Owner:  NLM     Status:  MEDLINE    
We prospectively studied 485 episodes of bacteremia in neutropenic patients with cancer. Viridans streptococci caused a total of 88 episodes (18%). Ten (11%) of these 88 cases were associated with serious complications: acute respiratory distress syndrome (ARDS) plus septic shock (5 cases), ARDS (3), and septic shock (2). Streptococcus mitis was the species most frequently isolated (7 of 10 episodes). Four viridans streptococci showed a diminished susceptibility to penicillin (MICs ranged from 0.25 to 4 microg/mL), and 5 strains were resistant to ceftazidime (MICs ranged from 2 to >32 microg/mL). Patients with viridans streptococcal bacteremia (VSB) who developed serious complications were compared with patients with VSB without complications. Severe oral mucositis (70% vs. 32.5%, respectively; P=.036), high-dose chemotherapy with cyclophosphamide (60% vs. 25%, respectively; P=.043), and allogeneic bone marrow transplantation (40% vs. 10%, respectively; P=.040) were the only variables found to be significantly associated with the development of complications. Neither a specific species of viridans streptococci nor resistance to penicillin was associated with the occurrence of complications. The mortality rate was higher in case patients than in control patients (80% vs. 17.5%, respectively; P<.001). Serious complications associated with VSB occur mainly in patients receiving high-dose chemotherapy with cyclophosphamide before allogeneic bone marrow transplantation who develop severe oral mucositis; these complications are associated with a high mortality rate.
A Marron; J Carratalà; E González-Barca; A Fernández-Sevilla; F Alcaide; F Gudiol
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2000-11-06
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  31     ISSN:  1058-4838     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-12-26     Completed Date:  2001-01-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1126-30     Citation Subset:  IM    
Service of Infectious Diseases, Ciutat Sanitària i Universitària de Bellvitge, Institut Català d'Oncologia, University of Barcelona, Spain.
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MeSH Terms
Bacteremia / complications*,  pathology
Microbial Sensitivity Tests
Middle Aged
Neoplasms / complications*
Neutropenia / complications*
Streptococcal Infections / complications*,  microbiology,  pathology
Streptococcus / drug effects,  isolation & purification*

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