DE BOCK R, COMETTA A, KERN W, AOUN M, CABALLERO D, ENGELHARD D, SCHAFFNER A, GALAZZO M, PAESMANS M, VANDENBERGH M, VISCOLI C; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. L-773.

EORTC-IATG, Brussels, Belgium

In the last 2 decades a net prevalence of Gram + over Gram - bacteremias(B) in NCP is observed. To assess whether this remains true and how fluoroquinolone prophylaxis(FQP) affects it, we compare data from EORTC-IATG trial XI (1993) = population X to data from trial XIV (2000)=population Y. Analysis of NCP enrolled by centers participating in both trials only, = populations X and Y, attempts to avoid confounding by center specific pathogen distributions.The 2 NCP populations are similar for age, underlying disease and duration of neutropenia. Comparing X to Y: incidence of B rises from 23%(232/987) to 28%(218/763);p=0.03 with an increased incidence of SAGNB: 6.5% (64/987) vs. 12%(92/763);p<0.001 due to Klebsiella spp.: 4/987 to 21/763; p<0.001 and. Enterobacter spp: 2/987 to7/763;p=0.05. Meanwhile, FQP is used much less frequently: 33%(253/763) vs. 52%(517/987);p<0.0001. Comparing X to Y there is a trend of increased overall incidence of B: 23%(84/386) vs.27%(94/341);p= 0.08 and a trend of increased incidence of SAGNB: 7.5%(29/386) vs.12%(41/341);p=0.05 Klebsiella spp 4/386 to 9/341;p= 0.16 ,and Enterobacter spp:0/386 to 2/341;p=0.22.The significant difference in the use of FQP 39%(133/341) vs. 50%(192/386); p=0.004 remains. Susceptibility testing by microbroth dilution or E-test on the strains sent to a reference laboratory shows a very low incidence of FQ resistant SAGNB among NCP not receiving 1/17 in X vs. 2/51 in Y and 0/6 in X vs. 0/22 in Y; p<0.0001.The resistance to fluoroquinolones concerns mainly E.coli: overall in trial XI 38%(12/32) of strains tested are resistant to FQ and in XIV only 20%(9/44);p=0.17. Ccl.:1.SAGNB increase in the study period. 2. The likelihood of FQ resistant SAGNB remains low in the absence of FQP indicating that resistance problems do not move into NCP populations given no FQ.

Publication Types:

• Meeting Abstracts

Keywords:

• Antibiotic Prophylaxis
• Bacteremia
• Clinical Trials as Topic
• Fluoroquinolones
• Humans
• Incidence
• Neutropenia
• drug therapy
• epidemiology
• therapy

Other ID:

• GWAIDS0029866

UI: 102269498

From Meeting Abstracts