CAPNOCYTOPHAGA BACTEREMIA - CLINICAL-FEATURES OF PATIENTS AND ANTIMICROBIAL SUSCEPTIBILITY OF ISOLATES

Capnocytophaga has been recognized as an opportunistic pathogen causin g systemic infections in immunocompromised individuals with granulocyt openia and oral ulceration. Treatment of Capnocytophaga infection is o ften empiric. We retrospectively analyzed the clinical features of all patients with Capnocytophaga bacteremia seen at the National Taiwan U niversity Hospital between January 1981 and December 1996 and the anti microbial susceptibility of the isolates recovered from these patients . All the patients had underlying diseases, namely neoplastic disease (9 patients), hyperthyroidism (1), and bronchiectasis and tetralogy of Fallot (1). The clinical features of these patients were primary bact eremia (10) and pneumonia (1). Nine patients had nosocomial bacteremia and 10 patients had monomicrobial bacteremia. None had septic shock. All the patients responded well to appropriate antimicrobial therapy a nd survived. All isolates were susceptible to amoxicillin-clavulanate, imipenem, ciprofloxacin, erythromycin, clindamycin, tetracycline, and chloramphenicol but resistant to aminoglycosides and sulfamethoxazole trimethoprim. The susceptibilities to penicillin, ampicillin, piperaci llin, cephalosporins, and aztreonam were variable. Capnocytophaga bact eremia should be included in the differential diagnosis of febrile neu tropenia in immunocompromised patients, especially in the presence of oral mucositis and ulceration.