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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
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Bacteremia in patients with hematologic malignancies

F D Wang1, Y M Liu, C Y Liu

  • 1Department of Medicine, Veterans General Hospital-Taipei, Taiwan.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|July 3, 1998
PubMed
Summary

Empirical antibiotic therapy for bacteremia in hematologic malignancy patients requires individualized institutional approaches. Gram-negative bacteria remain predominant pathogens, necessitating targeted antibiotic combinations like amikacin with specific agents for effective treatment.

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Area of Science:

  • Infectious Diseases
  • Hematology
  • Clinical Microbiology

Background:

  • Bacteremia in hematologic malignancy patients poses a significant clinical challenge.
  • Empirical antibiotic therapy decisions must consider local microbial patterns and resistance profiles.
  • International reports suggest a shift towards gram-positive bacteremia, contrasting with local observations.

Purpose of the Study:

  • To investigate the spectrum of bacterial isolates and their antibiotic sensitivities in patients with hematologic malignancies.
  • To guide empirical antibiotic therapy selection based on local data.
  • To compare local findings with international trends in bacteremia pathogens.

Main Methods:

  • Retrospective analysis of 185 bacteremia episodes in 140 hematologic malignancy patients (1995-1996).
  • Identification and antibiotic susceptibility testing of bacterial isolates.
  • Mortality rate assessment for different pathogens.

Main Results:

  • Gram-negative organisms predominated (72.7%), contrary to international trends.
  • Common gram-negative isolates included Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterobacter cloacae.
  • High mortality rates were observed for gram-negative bacteremia and methicillin-resistant Staphylococcus aureus (MRSA).

Conclusions:

  • Local data indicate gram-negative bacteria remain the primary cause of bacteremia in this patient population.
  • Amikacin combined with cefoperazone, ceftazidime, ciprofloxacin, or imipenem is recommended for empirical therapy.
  • Institutional antimicrobial stewardship programs should be informed by ongoing surveillance of local resistance patterns.