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Influence of patient age on the frequency of occurrence and antimicrobial resistance patterns of isolates from hematology/oncology patients: report from the Chemotherapy Alliance for Neutropenics and the Control of Emerging Resistance Program (North America).
Diagn Microbiol Infect Dis. 2006 Sep; 56(1):75-82.DM

Abstract

The Chemotherapy Alliance for Neutropenics and the Control of Emerging Resistance Program (CANCER) monitored the susceptibility of pathogens recovered in hematology/oncology centers from 2000 to 2002. A total of 3970 isolates from 32 hospitals (26 United States, 6 Canada) were analyzed at a central location (JMI Laboratories, North Liberty, IA) for trends in pathogen occurrence and reference antimicrobial susceptibility profiles. The top 5 ranking pathogens were Staphylococcus aureus (19.3%), coagulase-negative staphylococci (CoNS) (14.1%), Escherichia coli (13.4%), Enterococcus spp. (10.2%), and Klebsiella spp. (9.5%). A total of 35.5% of S. aureus and 78.8% of CoNS were resistant to oxacillin, whereas 22.0% of Enterococcus spp. were resistant to vancomycin. E. coli and Klebsiella spp. were highly susceptible (>90%) to piperacillin/tazobactam, 3rd-generation cephalosporins, and ciprofloxacin, but 3.9% and 2.4% of these species, respectively, met screening criteria for extended spectrum beta-lactamase production. Enterobacter spp. were less susceptible to piperacillin/tazobactam, ceftazidime, and ceftriaxone (83.7-88.2%) because of Amp C production and were most inhibited by cefepime and imipenem. Amikacin and polymyxin B were very active against Pseudomonas aeruginosa (97.4-97.7% susceptible). Prevalence of S. aureus, E. coli, Enterobacter spp., and Klebsiella spp. increased significantly (+48% to 98%) with age, whereas CoNS and viridans group streptococci decreased markedly (-62% to 69%) with advancing age. The isolation of Gram-positive pathogens declined (55% to 47%) with age (< or =14 to > or =65 years). Fluoroquinolones generally exhibited decreased susceptibility with increased age against nearly all listed pathogens. Oxacillin resistance rates for S. aureus increased with age (6-46%) as did vancomycin resistance rates for enterococci (nil in < or =14 years group to 18-24% in adults). Pathogens infecting neutropenic patients did not reflect greater resistance than those found in the general hospitalized patients. Gram-positive organisms were only slightly more predominant (53.4%), and cited age-related variations in pathogen occurrence and/or susceptibility patterns by species must be considered for empiric regimes for hematology and oncology patients.

Authors+Show Affiliations

JMI Laboratories, Inc., North Liberty, IA 52317, USA. jeff-kirby@jmilabs.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16876375

Citation

Kirby, Jeffrey T., et al. "Influence of Patient Age On the Frequency of Occurrence and Antimicrobial Resistance Patterns of Isolates From Hematology/oncology Patients: Report From the Chemotherapy Alliance for Neutropenics and the Control of Emerging Resistance Program (North America)." Diagnostic Microbiology and Infectious Disease, vol. 56, no. 1, 2006, pp. 75-82.
Kirby JT, Fritsche TR, Jones RN. Influence of patient age on the frequency of occurrence and antimicrobial resistance patterns of isolates from hematology/oncology patients: report from the Chemotherapy Alliance for Neutropenics and the Control of Emerging Resistance Program (North America). Diagn Microbiol Infect Dis. 2006;56(1):75-82.
Kirby, J. T., Fritsche, T. R., & Jones, R. N. (2006). Influence of patient age on the frequency of occurrence and antimicrobial resistance patterns of isolates from hematology/oncology patients: report from the Chemotherapy Alliance for Neutropenics and the Control of Emerging Resistance Program (North America). Diagnostic Microbiology and Infectious Disease, 56(1), 75-82.
Kirby JT, Fritsche TR, Jones RN. Influence of Patient Age On the Frequency of Occurrence and Antimicrobial Resistance Patterns of Isolates From Hematology/oncology Patients: Report From the Chemotherapy Alliance for Neutropenics and the Control of Emerging Resistance Program (North America). Diagn Microbiol Infect Dis. 2006;56(1):75-82. PubMed PMID: 16876375.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of patient age on the frequency of occurrence and antimicrobial resistance patterns of isolates from hematology/oncology patients: report from the Chemotherapy Alliance for Neutropenics and the Control of Emerging Resistance Program (North America). AU - Kirby,Jeffrey T, AU - Fritsche,Thomas R, AU - Jones,Ronald N, Y1 - 2006/07/28/ PY - 2005/11/08/received PY - 2006/06/02/revised PY - 2006/06/06/accepted PY - 2006/8/1/pubmed PY - 2006/10/25/medline PY - 2006/8/1/entrez SP - 75 EP - 82 JF - Diagnostic microbiology and infectious disease JO - Diagn Microbiol Infect Dis VL - 56 IS - 1 N2 - The Chemotherapy Alliance for Neutropenics and the Control of Emerging Resistance Program (CANCER) monitored the susceptibility of pathogens recovered in hematology/oncology centers from 2000 to 2002. A total of 3970 isolates from 32 hospitals (26 United States, 6 Canada) were analyzed at a central location (JMI Laboratories, North Liberty, IA) for trends in pathogen occurrence and reference antimicrobial susceptibility profiles. The top 5 ranking pathogens were Staphylococcus aureus (19.3%), coagulase-negative staphylococci (CoNS) (14.1%), Escherichia coli (13.4%), Enterococcus spp. (10.2%), and Klebsiella spp. (9.5%). A total of 35.5% of S. aureus and 78.8% of CoNS were resistant to oxacillin, whereas 22.0% of Enterococcus spp. were resistant to vancomycin. E. coli and Klebsiella spp. were highly susceptible (>90%) to piperacillin/tazobactam, 3rd-generation cephalosporins, and ciprofloxacin, but 3.9% and 2.4% of these species, respectively, met screening criteria for extended spectrum beta-lactamase production. Enterobacter spp. were less susceptible to piperacillin/tazobactam, ceftazidime, and ceftriaxone (83.7-88.2%) because of Amp C production and were most inhibited by cefepime and imipenem. Amikacin and polymyxin B were very active against Pseudomonas aeruginosa (97.4-97.7% susceptible). Prevalence of S. aureus, E. coli, Enterobacter spp., and Klebsiella spp. increased significantly (+48% to 98%) with age, whereas CoNS and viridans group streptococci decreased markedly (-62% to 69%) with advancing age. The isolation of Gram-positive pathogens declined (55% to 47%) with age (< or =14 to > or =65 years). Fluoroquinolones generally exhibited decreased susceptibility with increased age against nearly all listed pathogens. Oxacillin resistance rates for S. aureus increased with age (6-46%) as did vancomycin resistance rates for enterococci (nil in < or =14 years group to 18-24% in adults). Pathogens infecting neutropenic patients did not reflect greater resistance than those found in the general hospitalized patients. Gram-positive organisms were only slightly more predominant (53.4%), and cited age-related variations in pathogen occurrence and/or susceptibility patterns by species must be considered for empiric regimes for hematology and oncology patients. SN - 0732-8893 UR - https://www.unboundmedicine.com/medline/citation/16876375/Influence_of_patient_age_on_the_frequency_of_occurrence_and_antimicrobial_resistance_patterns_of_isolates_from_hematology/oncology_patients:_report_from_the_Chemotherapy_Alliance_for_Neutropenics_and_the_Control_of_Emerging_Resistance_Program__North_America__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0732-8893(06)00209-4 DB - PRIME DP - Unbound Medicine ER -