Supportive Care in Cancer

, Volume 16, Issue 9, pp 1085–1088

Emergence of MRSA in positive blood cultures from patients with febrile neutropenia—a cause for concern

  • Patrick G. Morris
  • Tidi Hassan
  • Mairead McNamara
  • Astrid Hassan
  • Rebecca Wiig
  • Liam Grogan
  • Oscar S. Breathnach
  • Edmond Smyth
  • Hilary Humphreys
Original Article

Abstract

Goals of work

Febrile neutropenia (FN) causes considerable morbidity in patients on cytotoxic chemotherapy. Recently, there has been a trend towards fewer Gram-negative and more Gram-positive infections with increasing antibiotic resistance. To assess these patterns, data from a supra-regional cancer centre in Ireland were reviewed.

Patients and methods

A 5-year review of all positive blood cultures in patients undergoing anti-cancer chemotherapy was carried out.

Main results

Eight hundred and ninety-four patients were reviewed. The mean incidence of FN was 64.2 cases per year. Eight hundred and forty-six blood culture specimens were taken and 173 (20.4%) were culture positive. The isolated organisms were Gram positive (71.1%), Gram negative (27.8%) and fungal (1.1%). Of the Gram-positive organisms, 75.6% were staphylococci. Of these, 67.8% were coagulase-negative staphylococci and 30.1% were Staphylococci aureus. Amongst the S. aureus, 89.3% were methicillin-resistant (MRSA). Vancomycin-resistant enterococci were not identified as a cause of positive blood cultures.

Conclusions

Amongst patients with cancer who develop FN in our hospital, Gram-positive bacteria account for the largest proportion. The high proportion of MRSA as a cause of positive blood cultures is of concern.

Keywords

Febrile neutropenia MRSA VRE Blood cultures 

Abbreviations

FN

febrile neutropenia

MRSA

methicillin-resistant Staphylococcus aureus

VRE

vancomycin-resistant enterococci

CSFs

colony-stimulating factors

S. aureus

Staphylococcus aureus

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Patrick G. Morris
    • 1
    • 3
  • Tidi Hassan
    • 1
  • Mairead McNamara
    • 1
  • Astrid Hassan
    • 1
  • Rebecca Wiig
    • 1
  • Liam Grogan
    • 1
  • Oscar S. Breathnach
    • 1
  • Edmond Smyth
    • 2
  • Hilary Humphreys
    • 2
  1. 1.Department of OncologyBeaumont HospitalDublinIreland
  2. 2.Department of MicrobiologyBeaumont Hospital and Royal College of Surgeons in IrelandDublinIreland
  3. 3.Cancer Clinical Trials Office, Cancer CentreBeaumont HospitalDublinIreland

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