gms | German Medical Science

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Deutsche Gesellschaft für Infektiologie,
Deutsche AIDS-Gesellschaft,
Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit,
Paul-Ehrlich-Gesellschaft für Chemotherapie

23.06. - 26.06.2010, Köln

Bloodstream infections during neutropenia: Which pathogens are involved in transplanted haematology patients? Evaluation of ONKO-KISS-Data

Sepsis in der Neutropenie: Welches Erregerspektrum findet sich bei transplantierten hämatologischen Patienten? Auswertung von ONKO-KISS-Daten

Meeting Abstract

  • D. Luft - University Medical Center Freiburg, Department of Environmental Health Sciences, Division of Infection Control and Hospital Epidemiology, Freiburg, Germany
  • R. Babikir - University Medical Center Freiburg, Department of Environmental Health Sciences, Division of Infection Control and Hospital Epidemiology, Freiburg, Germany
  • H. Bertz - University Medical Center Freiburg, Department of Medicine I, Hematology and Oncology, Freiburg, Germany
  • A.F. Widmer - University Hospital Basel, Division of Infectious Diseases and Hospital Epidemiology, Basel, Switzerland
  • W.V. Kern - University Medical Center Freiburg, Department of Medicine, Center for Infectious Diseases & Travel Medicine, Freiburg, Germany
  • M. Dettenkofer - University Medical Center Freiburg, Department of Environmental Health Sciences, Division of Infection Control and Hospital Epidemiology, Freiburg, Germany
  • ONKO-KISS Study Group

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010). Köln, 23.-26.06.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP31

DOI: 10.3205/10kit087, URN: urn:nbn:de:0183-10kit0874

Veröffentlicht: 2. Juni 2010

© 2010 Luft et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objectives: Neutropenic haematology patients are at high risk for bloodstream infections. Current reference data from the ongoing multicenter surveillance project ONKO-KISS demonstrate incidence densities of 8.7 and 15.5 per 1,000 neutropenic days (ND) in patients undergoing autologous or allogeneic stem cell transplantation (TX), respectively. The project was initiated by the German National Reference Centre for Surveillance of Nosocomial Infections in 2000. Derived from ONKO-KISS we present data on pathogens detected in BSI cases over a period of 5 years.

Methods: Nosocomial bloodstream infections are identified using CDC definitions for laboratory-confirmed BSI [for detailed information see: CID 2005; 40:926, or in German language: http://www.nrz-hygiene.de/surveillance/onko.htm]. Data on BSI and pathogens detected in blood cultures are reported to the Reference Centre for Surveillance.

Results: From 01/2004 up to 12/2008 22 centres participated. 5,800 patients were included (86,130 ND). 910 cases of nosocomial BSI were diagnosed and a total of 1,020 pathogens were detected. 695 (68%) gram-positive bacteria, 294 (29%) gram negatives and 31 (3%) fungi. Overall incidence density of BSI was 10.6 per 1,000 ND, BSI rate was 15.7 per 100 patients.

The 695 gram-positive bacteria divided into 469 (67%) coagulase negative staphylococci (CNS), 102 (15%) enterococci (thereof 16 [16%] vancomycin-resistant enterococci [VRE]), 69 (10%) streptococci, 21 (3%) S. aureus (thereof 6 [29%] methicillin-resistant S. aureus [MRSA]) and 34 (5%) others.

The 294 gram-negatives divided into 161 (55%) E. coli (thereof 15 [9%] extended-spectrum ß-lactamase [ESBL]-producers), 39 (13%) Pseudomonas spp., 29 (10%) Klebsiella spp. (thereof 1 [3%] ESBL-producer, 23 (8%) Enterobacter spp., 14 (5%) Stenotrophomonas spp., and 28 (10%) others.

Comparison of data per year shows varying fractions of microorganisms but no apparent trend.

Conclusions: Gram-positive microorganisms (and thereof CNS) are the predominant microorganisms detected in neutropenic haematology patients with BSI. Most frequently detected gram-negative pathogen is E. coli.

Even though only low absolute numbers of multi-resistant pathogens were found, fractions of MRSA, VRE and ESBL-producers within the particular pathogen groups seem to be rather high in this patient group.

No marked changes in the relation between gram-positive and gram-negative pathogens are evident over time.