BACTEREMIA DUE TO ENTEROBACTER SPP IN CANCER-PATIENTS - ANALYSIS OF 51 EPISODES

Fifty one episodes of bacteremia due to Enterobacter spp. appearing wi thin 7 years among 12301 admissions in a single cancer institution wer e studied for risk factors, clinical presentation and outcome. Fifteen episodes were due to Enterobacter aerogenes, 23 due to E. cloacae and 13 due to E. agglomerans. The proportion of bacteremia due to Enterob acter spp. among Gram-negative bacteremias was 10.1% and infection ass ociated mortality was 13.8%. The incidence in 1989-1995 varied from 3. 7 to 8.7% and was relatively stable. Most common risk factors were: so lid tumors as underlying disease, central venous catheter insertion, p rior surgery and prior chemotherapy within 48 h. Neutropenia and urina ry catheters were not at high risk in either one of the patients subgr oups. Comparing two subgroups of 51 bacteremias, monomicrobial and pol ymicrobial (when Enterobacter spp. was isolated from blood culture wit h other microorganism), previous chemotherapy, vascular catheter inser tion and prior endoscopy were more frequently associated with polymicr obial Enterobacter spp. bacteremia. There was also differences in infe ction associated mortality: bacteremias due to Enterobacter spp. only had significantly lower mortality in comparison to polymicrobial Enter obacter spp. bacteremias (3.3 vs. 29.3%; P < 0.02). Susceptibility of Enterobacter spp. strains isolated from 51 episodes was stable and sho wed only two episodes due to quinolone-resistant strains, both in 1992 despite of the use of ofloxacin in prophylaxis of neutropenic patient s since 1990 in our institute. Ninety-two to 94% of all strains were s usceptible to aminoglycosides, 96-98% to ofloxacin and ciprofloxacin, respectively and 94.9% to meropenem but only 75.5% to ceftazidime. (C) 1997 Elsevier Science B.V.