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

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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.

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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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Acknowledgements

The authors would like to thank Maurice Mallen for his assistance in reviewing the laboratory data.

Author information

Authors and Affiliations

  1. Department of Oncology, Beaumont Hospital, Dublin 9, Dublin, Ireland

    Patrick G. Morris, Tidi Hassan, Mairead McNamara, Astrid Hassan, Rebecca Wiig, Liam Grogan & Oscar S. Breathnach

  2. Department of Microbiology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin 9, Dublin, Ireland

    Edmond Smyth & Hilary Humphreys

  3. Cancer Clinical Trials Office, Cancer Centre, Beaumont Hospital, Dublin 9, Dublin, Ireland

    Patrick G. Morris

Authors
  1. Patrick G. Morris
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  2. Tidi Hassan
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  3. Mairead McNamara
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  4. Astrid Hassan
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  5. Rebecca Wiig
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  6. Liam Grogan
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  7. Oscar S. Breathnach
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  8. Edmond Smyth
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  9. Hilary Humphreys
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Corresponding author

Correspondence to Patrick G. Morris.

Additional information

The Cancer Centre Beaumont hospital is affiliated to National Surgical Adjuvant Breast and Bowel Project, Eastern Co-operative Oncology Group and All Ireland Co-operative Oncology Research Group and Health Research Board.

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Morris, P.G., Hassan, T., McNamara, M. et al. Emergence of MRSA in positive blood cultures from patients with febrile neutropenia—a cause for concern. Support Care Cancer 16, 1085–1088 (2008). https://doi.org/10.1007/s00520-007-0398-5

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  • DOI: https://doi.org/10.1007/s00520-007-0398-5

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