Emergence of MRSA in positive blood cultures from patients with febrile neutropenia—a cause for concern
Emergence of MRSA in positive blood cultures from patients with febrile neutropenia—a cause for concern
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发热性中性粒细胞减少症患者血培养阳性中出现 MRSA——值得关注
DOI：
10.1007/s00520-007-0398-5
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发表时间：
2008
影响因子：
3.1
通讯作者：
H. Humphreys
中科院分区：
文献类型：
--
作者：
P. Morris;T. Hassan;M. McNamara;Astrid S Hassan;R. Wiig;L. Grogan;O. Breathnach;E. Smyth;H. Humphreys
工作目的中性粒细胞减少症(FN)在接受细胞毒性化疗的患者中会导致相当大的发病率。最近，随着抗生素耐药性的增加，有一种趋势，即革兰氏阴性感染减少，革兰氏阳性感染增加。为了评估这些模式，我们回顾了来自爱尔兰一个跨区域癌症中心的数据。患者和方法对接受抗癌化疗的患者进行了为期5年的血培养阳性回顾。主要结果回顾了894名患者。FN的年均发病率为64.2例。共采集血培养标本846份，培养阳性率为20.4%。分离出的细菌以革兰氏阳性(71.1%)、革兰阴性(27.8%)和真菌(1.1%)为主。革兰氏阳性菌中，葡萄球菌占75.6%。其中凝固酶阴性葡萄球菌占67.8%，金黄色葡萄球菌占30.1%。金黄色葡萄球菌中89.3%为耐甲氧西林(MRSA)。结论在本院发生FN的癌症患者中，革兰阳性菌所占比例最大。耐甲氧西林金黄色葡萄球菌作为血培养阳性的原因比例很高，令人担忧。
Goals of workFebrile 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 methodsA 5-year review of all positive blood cultures in patients undergoing anti-cancer chemotherapy was carried out.Main resultsEight 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% wereStaphylococci aureus. Amongst theS.aureus, 89.3% were methicillin-resistant (MRSA). Vancomycin-resistant enterococci were not identified as a cause of positive blood cultures.ConclusionsAmongst 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.