Aetiology and resistance in bacteraemias among adult and paediatric haematology and cancer patients

Małgorzata Mikulska, Claudio Viscoli, Christina Orasch, David M. Livermore, Diana Averbuch, Catherine Cordonnier, Murat Akova

Research output: Contribution to journalArticle

Abstract

Objectives: A knowledge of current epidemiology and resistance patterns is crucial to the choice of empirical treatment for bacteraemias in haematology and cancer patients. Methods: A literature review on bacteraemias in cancer patients considered papers published between January 1st 2005 and July 6th 2011. Additionally, in 2011, a questionnaire on the aetiology and resistance in bacteraemias, and empirical treatment, was sent to participants of the European Conference on Infections in Leukemia (ECIL) meetings; recipients were from 80 haematology centres. Results: For the literature review, data from 49 manuscripts were analysed. The questionnaire obtained responses from 39 centres in 18 countries. Compared with the published data, the questionnaire reported more recent data, and showed a reduction of the Gram-positive to Gram-negative ratio (55%:45% vs. 60%:40%), increased rates of enterococci (8% vs. 5%) and Enterobacteriaceae (30% vs. 24%), a decreased rate of Pseudomonas aeruginosa (5% vs. 10%), and lower resistance rates for all bacteria. Nevertheless the median rates of ESBL-producers (15-24%), aminoglycoside-resistant Gram-negatives (5-14%) and carbapenem-resistant P. aeruginosa (5-14%) were substantial, and significantly higher in South-East vs. North-West Europe. Conclusions: The published epidemiological data on bacteraemias in haematology are scanty and mostly dated. Important differences in aetiology and resistance exist among centres. Updated analyses of the local epidemiology are mandatory to support appropriate empirical therapy.

Original languageEnglish
Pages (from-to)321-331
Number of pages11
JournalJournal of Infection
Volume68
Issue number4
DOIs
Publication statusPublished - 2014

Keywords

  • Antimicrobial resistance
  • Bloodstream infection
  • Cancer
  • Multidrug resistant (MDR) bacteria
  • Sepsis
  • Transplantation

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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