BACTEREMIA DUE TO METHICILLIN-RESISTANT STAPHYLOCOCCI OCCURS MORE FREQUENTLY IN NEUTROPENIC PATIENTS WHO RECEIVED ANTIMICROBIAL PROPHYLAXISAND IS ASSOCIATED WITH HIGHER MORTALITY IN COMPARISON TO METHICILLIN-SENSITIVE BACTEREMIA

Bacteriemia due to coagulase-negative staphylococci (CNS) resistant to methicillin and sensitive only to glycopeptides in 220 cancer patient s was prospectively analyzed for risk factors and outcome, A group of 33 cases of bacteriemia with CNS-sensitive only to glycopeptides was c ompared with a group of 187 cases with CNS sensitive to methicillin. A ll cases appeared in two affiliated major cancer institutes in Bratisl ava with the same antibiotic policy. Univariate analysis showed differ ences in recorded risk factors: acute leukemia (48 vs. 33%, P < 0.05), neutropenia (57 vs. 32%, P < 0.045), previous prophylaxis with quinol ones (30 vs. 11%, P < 0.01) and penicillin-V (15 vs. 3%, P < 0.02) and previous colonisation with CNS (27 vs. 3%, P < 0.01) were more freque ntly associated with bacteriemia resistant to methicillin and sensitiv e only to glycopeptides. Attributable mortality was also higher in thi s subgroup in comparison to bacteriemias with CNS sensitive to methici llin (12 vs. 3%, P < 0.05) however, overall mortality was similar. Bac teriemias due to CNS caused by sensitivity only to glycopeptides occur ed more frequently in neutropenic patients (1), with acute leukemia (2 ), receiving quinolone and penicillin prophylaxis (3), and previously colonized (4), patients and had worse prognosis in comparison to those with methicillin-sensitive staphylococcal bacteriemias. (C) 1998 Else vier Science B.V./International Society of Chemotherapy. All rights re served.