STAPHYLOCOCCAL BACTEREMIA IN CANCER-PATIENTS - RISK-FACTORS AND OUTCOME IN 134 EPISODES PRIOR TO AND AFTER INTRODUCTION OF QUINOLONES INTO INFECTION PREVENTION IN NEUTROPENIA

A total of 134 episodes of staphylococcal bacteremia (SBE) appearing a mong 9987 admissions, and 979 episodes of bacteremia in cancer patient s within 5 years, were analyzed for risk factors, clinical course and outcome; 64 were monomicrobial and 70 polymicrobial. The most frequent risk factors were acute leukemia, catheter insertion, long-lasting ne utropenia, and prior prophylaxis with quinolones. There was no signifi cant difference between polymicrobial and monomicrobial SBE in risk fa ctors. The two groups differed only in the source of bacteremia (gastr ointestinal and respiratory-tract infections were more common in monom icrobial SBE) and etiology - Staphylococcus aureus appeared more frequ ently in monomicrobial than in polymicrobial bacteremia (20.3% compare d to 4.3%, P<0.05). More complications (14.3%) such as abscesses, endo carditis, etc. appeared in the group of polymicrobial SBE (P<0.05). No difference was observed in clinical course and outcome between monomi crobial and polymicrobial SBE. The incidence of SBE has increased sinc e 1991, when quinolones were first used in prophylaxis in afebrile neu tropenia at our center; however, the infection-associated mortality in monomicrobial SBE was low (4.3%).