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Bacteremia in granulocytopenic patients in a tertiary-care general hospital.

Publication ,  Journal Article
Ehni, WF; Reller, LB; Ellison, RT
Published in: Rev Infect Dis
1991

Episodes of bacteremia in granulocytopenic patients during 1985 and 1986 at a tertiary-care general hospital were reviewed to assess the adequacy of current empiric antimicrobial therapy. The major pathogens in these cases were Pseudomonas aeruginosa, Enterobacteriaceae organisms, and Staphylococcus epidermidis. This combination of pathogens differed from that found at the same facility from 1975 to 1977, when Staphylococcus aureus and streptococci predominated. When apparent, the sources of infection were predominantly venous catheters, the lower respiratory tract, and the urinary tract; most frequently there was no identifiable focus. S. epidermidis and streptococci were isolated more frequently during initial episodes of febrile bacteremia, and P. aeruginosa was isolated more often during subsequent episodes. If a narrow definition for therapeutic outcome is used, only 38% of episodes had a favorable response; response rates were no different with appropriate or inappropriate therapy. The low response rate may have been related to the use of data from the previous review to guide empiric therapy and to the subsequent inadequate treatment of infections caused by Pseudomonas and Enterobacter organisms. The overall mortality per total bacteremic episodes was 19%, and the primary factor associated with mortality was pneumonia (P less than .0001). This study emphasizes the need for ongoing surveillance of local patterns of bacteremia to direct empiric therapy.

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Published In

Rev Infect Dis

DOI

ISSN

0162-0886

Publication Date

1991

Volume

13

Issue

4

Start / End Page

613 / 619

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Staphylococcus epidermidis
  • Staphylococcal Infections
  • Retrospective Studies
  • Pseudomonas Infections
  • Humans
  • Hospitals, University
  • Hospitals, General
  • Enterobacteriaceae Infections
  • Colorado
 

Citation

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Ehni, W. F., Reller, L. B., & Ellison, R. T. (1991). Bacteremia in granulocytopenic patients in a tertiary-care general hospital. Rev Infect Dis, 13(4), 613–619. https://doi.org/10.1093/clinids/13.4.613
Ehni, W. F., L. B. Reller, and R. T. Ellison. “Bacteremia in granulocytopenic patients in a tertiary-care general hospital.Rev Infect Dis 13, no. 4 (1991): 613–19. https://doi.org/10.1093/clinids/13.4.613.
Ehni WF, Reller LB, Ellison RT. Bacteremia in granulocytopenic patients in a tertiary-care general hospital. Rev Infect Dis. 1991;13(4):613–9.
Ehni, W. F., et al. “Bacteremia in granulocytopenic patients in a tertiary-care general hospital.Rev Infect Dis, vol. 13, no. 4, 1991, pp. 613–19. Pubmed, doi:10.1093/clinids/13.4.613.
Ehni WF, Reller LB, Ellison RT. Bacteremia in granulocytopenic patients in a tertiary-care general hospital. Rev Infect Dis. 1991;13(4):613–619.

Published In

Rev Infect Dis

DOI

ISSN

0162-0886

Publication Date

1991

Volume

13

Issue

4

Start / End Page

613 / 619

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Staphylococcus epidermidis
  • Staphylococcal Infections
  • Retrospective Studies
  • Pseudomonas Infections
  • Humans
  • Hospitals, University
  • Hospitals, General
  • Enterobacteriaceae Infections
  • Colorado