RESISTANCE PATTERN OF 2,816 ISOLATES ISOLATED FROM 17,631 BLOOD CULTURES AND ETIOLOGY OF BACTEREMIA AND FUNGEMIA IN A SINGLE CANCER INSTITUTION

The resistance pattern of 2 816 isolates from 17 631 blood cultures an d the etiology of isolates causing bacteremia and fungemia among 14 59 1 admissions were investigated in an 80-bed single cancer institute du ring seven years (1990-1996) under the same empiric therapeutic antibi otic policy but with different prophylactic strategies. No change was found in the proportion of Gram-positive versus Gram-negative bacteria isolated from bacteremias (70% vs. 30%) during the past seven years. Furthermore, the proportion of coagulase-negative staphylococci and en terococci was about the same before and after the introduction of oflo xacin in prophylaxis. However, the proportion of Pseudomonas aeruginos a and Stenotrophomonas maltophilia causing bacteremia increased. There was no increase in Candida krusei and Candida glabrata after the intr oduction of fluconazole into our prophylactic regimen in 1992. Penicil lin-resistance in viridans streptococci increased after penicillin was introduced into prophylaxis in acute leukemia in 1993. Until 1995 no quinolone-resistant Enterobacteriaceae were observed. Susceptibility t o quinolones did not significantly change within the past seven years in Enterobacteriaceae after their introduction to prophylaxis in 1991, but Pseudomonas aeruginosa decreased from 90 to 58.2%. Glycopeptide r esistance in enterococci and staphylococci was minimal in the observed period (0.9-4.3%).