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[Bacteremia in hematological malignant disorders].

Jens Hammerstrøm¹, Anja Løkken Røym, Frode Width Gran

¹Hematologisk avdeling St. Olavs Hospital 7006 Trondheim og Institutt for kreftforskning og molekylaer medisin Norges teknisk-naturvitenskapelige universitet. jens.hammerstrom@ntnu.no

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke

|August 16, 2008

Summary

Bacteremia in hematological cancer patients showed stable pathogen patterns and favorable antibiotic resistance over 15 years. Penicillin G and aminoglycoside remain suitable first-line treatments for suspected bacteremia in neutropenic patients.

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Area of Science:

Infectious Diseases
Hematology
Clinical Microbiology

Context:

Bacteremia is a common complication in patients undergoing cytostatic treatment for hematological malignancies.
Empirical antibiotic selection requires up-to-date knowledge of microbial resistance patterns.
This study analyzes blood culture data over a 10-year period, comparing it to the preceding 5 years.

Purpose:

To examine trends in microbial pathogens and antibiotic resistance in blood cultures from patients with hematological malignancies.
To assess changes in bacteremia patterns and resistance over a 15-year period (1995-2005).
To inform empirical antibiotic treatment strategies for neutropenic patients.

Summary:

A total of 373 isolates and 322 bacteremia episodes were analyzed in 225 patients, predominantly with acute leukemia or myeloma.
Escherichia coli, coagulase-negative staphylococci, and alpha-hemolytic streptococci were the most common pathogens.
While Enterococcus infections increased and were linked to higher mortality, overall antibiotic resistance rates remained favorable compared to European benchmarks.

Impact:

The study indicates minimal changes in pathogen profiles and antibiotic resistance over the observed period.
Mortality rates for bacteremia in acute leukemia patients were found to be acceptable (10.3% at 30 days).
Findings support the continued use of Penicillin G and aminoglycosides as first-line empirical therapy for suspected bacteremia in neutropenic patients in Norway.