Abstract | BACKGROUND: METHODS: This was a retrospective study of patients with diagnosis of AML during 2001-2007. RESULTS: A total of 81 patients were included in the study. Two hundred and ninetyone neutropenic episodes were studied, of which 181 were febrile. Bacteria isolated from blood cultures were mostly Gram-positives during the induction (80%) and Gram-negatives during the consolidation (72.4%) phases of chemotherapy. Resistance to ciprofloxacin was found in 78.9% of isolated E. coli and it was higher during consolidation and higher than the hospital rate. The production of extended spectrum betalactamases (ESBL) in E. coli strains was reported in 12.1%, below the reported hospital rate during the study period. CONCLUSIONS: Regular microbiology surveillance is needed to better understand the impact of levofloxacin prophylaxis in neutropenic patients. Our study shows that Gram-positive bacteria are predominant during the induction phase of chemotherapy and Gram-negatives during the consolidation. The rate of fluoroquinolone resistance in the latter setting, even higher than the hospital rate, may suggest to reconsider levofloxacin prophylaxis.
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Authors | Francesco Giuseppe De Rosa, Ilaria Motta, Ernesta Audisio, Chiara Frairia, Alessandro Busca, Giovanni Di Perri, Filippo Marmont |
Journal | BMC infectious diseases
(BMC Infect Dis)
Vol. 13
Pg. 563
(Dec 01 2013)
ISSN: 1471-2334 [Electronic] England |
PMID | 24289496
(Publication Type: Journal Article)
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Chemical References |
- Fluoroquinolones
- Ciprofloxacin
- Levofloxacin
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Topics |
- Adult
- Aged
- Antibiotic Prophylaxis
- Bacteremia
(epidemiology, etiology, microbiology, prevention & control)
- Bacteria
(classification, drug effects, genetics, isolation & purification)
- Bacterial Infections
(epidemiology, etiology, microbiology, prevention & control)
- Ciprofloxacin
(therapeutic use)
- Female
- Fluoroquinolones
- Humans
- Incidence
- Leukemia, Myeloid, Acute
(complications)
- Levofloxacin
(therapeutic use)
- Male
- Middle Aged
- Neutropenia
(complications)
- Retrospective Studies
- Young Adult
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