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Staphylococcus epidermidis Septicemia in Children With Leukemia and Lymphoma

Staphylococcus epidermidis Septicemia in Children With Leukemia and Lymphoma Abstract • Staphylococcus epidermidis is emerging as a cause of morbidity and mortality in immunocompromised patients. From January 1980 through June 1982, there were 150 episodes of septicemia in 92 children with leukemia and lymphoma at Memorial Sloan-Kettering Cancer Center, New York. Staphylococcus epidermidis was the fourth most common organism isolated, responsible for 12.7% of all septicemic episodes. Only nine of 53 isolates were sensitive to methicillin; all were sensitive to vancomycin. Staphylococcus epidermidis septicemia was associated with immunosuppressive chemotherapy (94.7%); broad-spectrum antibiotics (79.0%); catheters and drains (73.7%); neutropenia (63.2%); skin or soft-tissue infections (42.1%); prior septicemia (42.1%); concurrent polymicrobial septicemia (21.1%); and prolonged hospitalization (mean, 39 days). Of 19 patients, two died. Increased awareness of the pathogenic potential of S epidermidis in children with hematologic malignancies and prompt alteration of therapy to an effective antimicrobial agent, in most cases vancomycin hydrochloride, is required when the organism is isolated In patients known to be at risk with clinical evidence of septicemia. (AJDC 1984;138:715-719) References 1. Pizzo PA, Ladish S, Simm RM, et al: Increasing incidence of gram-positive sepsis in cancer patients . Med Pediatr Oncol 1977;5:242-244. 2. Ladisch S, Pizzo PA: Staphylococcus aureus sepsis in children with cancer . Pediatrics 1978;61:231-234. 3. DeClark Y, DeClark D, Rivard GE, et al: Septicemia in children with leukemia . Can Med Assoc J 1978;118:1523-1525. 4. Miser JS, Miser AW: Staphylococcus aureus sepsis in childhood malignancy . AJDC 1980;134:831-833. 5. Allen JB, Weiner LB: Pneumococcal sepsis in childhood leukemia and lymphoma . Pediatrics 1981;67:292-295. 6. Shrenbaum SC, Gardner P, Shillito J: Infections of cerebrospinal fluid shunts: Epidemiology, clinical manifestations, and therapy . J Infect Dis 1973;131:543-551. 7. Geraci JE, Hanson KC, Geulone ER: Endocarditis caused by coagulase-negative staphylococci . Mayo Clin Proc 1978;43:120-134. 8. Andriole VT, Lyons RW: Coagulase-negative staphylococcus . Ann NY Acad Sci 1970; 174:533-544.Crossref 9. Keys TF, Hewitt WL: Endocarditis due to micrococci and Staphylococcus epidermidis . Arch Intern Med 1973;132:216-220.Crossref 10. Archer GL, Tenebaum MJ: Antibiotic-resistant Staphylococcus epidermidis in patients undergoing cardiac surgery . Antimicrob Agents Chemother 1980;17:269-272.Crossref 11. Wilson TS, Stuart RD: Staphylococcus albus in wound infection and in septicemia . Can Med Assoc J 1965;93:8-16. 12. Maki DG, Weise CE, Sarafin HW: A semiquantitive culture method for identifying intravenous catheter-related infection . N Engl J Med 1977;296:1305-1309.Crossref 13. Forse RA, Dixon C, Bernard K, et al: Staphylococcus epidermidis: An important pathogen . Surgery 1979;86:507-514. 14. Sitges-Serra A, Puig P, Jaurrieta E, et al: Catheter sepsis due to Staphylococcus epidermidis during parenteral nutrition . Surg Gynecol Obstet 1980;151:481-483. 15. Christensen GD, Bisno AL, Parsi JT, et al: Nosocomial septicemia due to multiple antibioticresistant Staphylococcus epidermidis . Ann Intern Med 1982;96:1-10.Crossref 16. Bender JW, Hughes WT: Fatal Staphylococcus epidermidis sepsis following bone marrow transplantation . Johns Hopkins Med J 1980; 146:13-15. 17. Young LS: Nosocomial infections in the immunocompromised adult . Am J Med 1981;70: 398-404.Crossref 18. Battisti RM, Davies PA: Changing blood culture isolates in a referral neonatal intensive care unit . Arch Dis Child 1981;56:775-778.Crossref 19. Haley CE, Gregory WW, Donowitz LG, et al: Neonatal intensive care unit bloodstream infections: Emergence of gram-positive bacteria as major pathogens, abstract 691. Program and Abstracts of the 22nd Interscience Conference of Antimicrobial Agents and Chemotherapy, Miami Beach, Fla, Oct 6, 1982. 20. Fleer A, Visser MR, Gerards L, et al: Nosocomial septicemia with coagulase-negative staphylococci in a neonatal intensive care unit, abstract 693. Program and Abstracts of the 22nd Interscience Conference on Antimicrobial Agents and Chemotherapy, Miami Beach, Fla, Oct 6, 1982. 21. Munson DP, Thompson TR, Johnson DE, et al: Coagulase-negative staphylococcal septicemia: Experience in a newborn intensive care unit . J Pediatr 1982;101:602-605.Crossref 22. Blacklock HA, Pillar MV, Hill RS, et al: Use of modified subcutaneous right atrial catheter for venous access in leukemic patients . Lancet 1980;1:993-994.Crossref 23. Meyer D, Winston D, Chapin M, et al: Staphylococcal epidermidis bacteremia: An emerging problem in immunosuppressed patients and laminar-air flow units, abstract 682. Program and Abstracts of the 20th Interscience on Antimicrobial Agents and Chemotherapy, New Orleans, Sept 24, 1980. 24. Riben P, Kornachuk RE, Urias T, et al: Acquisition of antimicrobial-resistant coagulase-negative staphylococci in granulocytopenic patients, abstract 359. Program and Abstracts of the 20th Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, Sept 23, 1980. 25. Eng RHK, Wang C, Person A, et al: Species identification of coagulase-negative staphylococcal isolates from blood cultures . J Clin Microbiol 1982;15:439-442. 26. Lowder JN, Lazarus HM, Herzig RH: Bacteremias and fungemias in oncology patients with central venous catheters . Arch Intern Med 1982;142:1456-1459.Crossref 27. Shapiro ED, Wald ER, Nelson KA, et al: Broviac catheter-related bacteremia in oncology patients . AJDC 1982;136:679-681. 28. Wade JC, Schimpff SC, Newman KA, et al: Staphylococcus epidermidis: An increasing cause of infection in patients with granulocytopenia . Ann Intern Med 1982;97:503-508.Crossref 29. Winston DJ, Dudnick DV, Chapin M, et al: Coagulase-negative staphylococcal bacteremia in patients receiving immunosuppressive therapy . Arch Intern Med 1983;143:32-36.Crossref 30. Bauer AW, Kirby WMM, Sherris JC, et al: Antibiotic susceptibility testing by a standardized single disc method . Am J Clin Pathol 1966;43:493-498. 31. Gavin TL, Barry AL: Microdilution test procedures , in Lennette EH (ed): Manual of Clinical Microbiology . Washington, DC, American Society for Microbiology, 1980, pp 459-462. 32. Abrahm JL, Mullen JL: A prospective study of prolonged central venous access in leukemia . JAMA 1982;248:2868-2872.Crossref 33. Thomas JH, MacArthur RI, Pierce GI, et al: Hickman-Broviac catheters . Am J Surg 1980;140:791-796.Crossref 34. Starke ID, Donnelly P, Catovsky D, et al: Co-trimoxazole alone for prevention of bacterial infection in patients with acute leukemia . Lancet 1982;1:5-6.Crossref 35. Archer GL, Tenenbaum MJ, Haywood HB: Rifampin therapy of Staphylococcus epidermidis . JAMA 1980;240:751-753.Crossref 36. Archer GL: Antimicrobial susceptibility and selection of resistance among Staphylococcus epidermidis isolates recovered from patients with infections of indwelling foreign devices . Antimicrob Agents Chemother 1978; 14:353-359.Crossref 37. Schaad UB, McCracken GH: Pharmacology and efficacy of vancomycin for staphylococcal infections in children . Rev Infect Dis 1981;3( (suppl) ):282-288.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Staphylococcus epidermidis Septicemia in Children With Leukemia and Lymphoma

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References (39)

Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1984.02140460007005
Publisher site
See Article on Publisher Site

Abstract

Abstract • Staphylococcus epidermidis is emerging as a cause of morbidity and mortality in immunocompromised patients. From January 1980 through June 1982, there were 150 episodes of septicemia in 92 children with leukemia and lymphoma at Memorial Sloan-Kettering Cancer Center, New York. Staphylococcus epidermidis was the fourth most common organism isolated, responsible for 12.7% of all septicemic episodes. Only nine of 53 isolates were sensitive to methicillin; all were sensitive to vancomycin. Staphylococcus epidermidis septicemia was associated with immunosuppressive chemotherapy (94.7%); broad-spectrum antibiotics (79.0%); catheters and drains (73.7%); neutropenia (63.2%); skin or soft-tissue infections (42.1%); prior septicemia (42.1%); concurrent polymicrobial septicemia (21.1%); and prolonged hospitalization (mean, 39 days). Of 19 patients, two died. Increased awareness of the pathogenic potential of S epidermidis in children with hematologic malignancies and prompt alteration of therapy to an effective antimicrobial agent, in most cases vancomycin hydrochloride, is required when the organism is isolated In patients known to be at risk with clinical evidence of septicemia. (AJDC 1984;138:715-719) References 1. Pizzo PA, Ladish S, Simm RM, et al: Increasing incidence of gram-positive sepsis in cancer patients . Med Pediatr Oncol 1977;5:242-244. 2. Ladisch S, Pizzo PA: Staphylococcus aureus sepsis in children with cancer . Pediatrics 1978;61:231-234. 3. DeClark Y, DeClark D, Rivard GE, et al: Septicemia in children with leukemia . Can Med Assoc J 1978;118:1523-1525. 4. Miser JS, Miser AW: Staphylococcus aureus sepsis in childhood malignancy . AJDC 1980;134:831-833. 5. Allen JB, Weiner LB: Pneumococcal sepsis in childhood leukemia and lymphoma . Pediatrics 1981;67:292-295. 6. Shrenbaum SC, Gardner P, Shillito J: Infections of cerebrospinal fluid shunts: Epidemiology, clinical manifestations, and therapy . J Infect Dis 1973;131:543-551. 7. Geraci JE, Hanson KC, Geulone ER: Endocarditis caused by coagulase-negative staphylococci . Mayo Clin Proc 1978;43:120-134. 8. Andriole VT, Lyons RW: Coagulase-negative staphylococcus . Ann NY Acad Sci 1970; 174:533-544.Crossref 9. Keys TF, Hewitt WL: Endocarditis due to micrococci and Staphylococcus epidermidis . Arch Intern Med 1973;132:216-220.Crossref 10. Archer GL, Tenebaum MJ: Antibiotic-resistant Staphylococcus epidermidis in patients undergoing cardiac surgery . Antimicrob Agents Chemother 1980;17:269-272.Crossref 11. Wilson TS, Stuart RD: Staphylococcus albus in wound infection and in septicemia . Can Med Assoc J 1965;93:8-16. 12. Maki DG, Weise CE, Sarafin HW: A semiquantitive culture method for identifying intravenous catheter-related infection . N Engl J Med 1977;296:1305-1309.Crossref 13. Forse RA, Dixon C, Bernard K, et al: Staphylococcus epidermidis: An important pathogen . Surgery 1979;86:507-514. 14. Sitges-Serra A, Puig P, Jaurrieta E, et al: Catheter sepsis due to Staphylococcus epidermidis during parenteral nutrition . Surg Gynecol Obstet 1980;151:481-483. 15. Christensen GD, Bisno AL, Parsi JT, et al: Nosocomial septicemia due to multiple antibioticresistant Staphylococcus epidermidis . Ann Intern Med 1982;96:1-10.Crossref 16. Bender JW, Hughes WT: Fatal Staphylococcus epidermidis sepsis following bone marrow transplantation . Johns Hopkins Med J 1980; 146:13-15. 17. Young LS: Nosocomial infections in the immunocompromised adult . Am J Med 1981;70: 398-404.Crossref 18. Battisti RM, Davies PA: Changing blood culture isolates in a referral neonatal intensive care unit . Arch Dis Child 1981;56:775-778.Crossref 19. Haley CE, Gregory WW, Donowitz LG, et al: Neonatal intensive care unit bloodstream infections: Emergence of gram-positive bacteria as major pathogens, abstract 691. Program and Abstracts of the 22nd Interscience Conference of Antimicrobial Agents and Chemotherapy, Miami Beach, Fla, Oct 6, 1982. 20. Fleer A, Visser MR, Gerards L, et al: Nosocomial septicemia with coagulase-negative staphylococci in a neonatal intensive care unit, abstract 693. Program and Abstracts of the 22nd Interscience Conference on Antimicrobial Agents and Chemotherapy, Miami Beach, Fla, Oct 6, 1982. 21. Munson DP, Thompson TR, Johnson DE, et al: Coagulase-negative staphylococcal septicemia: Experience in a newborn intensive care unit . J Pediatr 1982;101:602-605.Crossref 22. Blacklock HA, Pillar MV, Hill RS, et al: Use of modified subcutaneous right atrial catheter for venous access in leukemic patients . Lancet 1980;1:993-994.Crossref 23. Meyer D, Winston D, Chapin M, et al: Staphylococcal epidermidis bacteremia: An emerging problem in immunosuppressed patients and laminar-air flow units, abstract 682. Program and Abstracts of the 20th Interscience on Antimicrobial Agents and Chemotherapy, New Orleans, Sept 24, 1980. 24. Riben P, Kornachuk RE, Urias T, et al: Acquisition of antimicrobial-resistant coagulase-negative staphylococci in granulocytopenic patients, abstract 359. Program and Abstracts of the 20th Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, Sept 23, 1980. 25. Eng RHK, Wang C, Person A, et al: Species identification of coagulase-negative staphylococcal isolates from blood cultures . J Clin Microbiol 1982;15:439-442. 26. Lowder JN, Lazarus HM, Herzig RH: Bacteremias and fungemias in oncology patients with central venous catheters . Arch Intern Med 1982;142:1456-1459.Crossref 27. Shapiro ED, Wald ER, Nelson KA, et al: Broviac catheter-related bacteremia in oncology patients . AJDC 1982;136:679-681. 28. Wade JC, Schimpff SC, Newman KA, et al: Staphylococcus epidermidis: An increasing cause of infection in patients with granulocytopenia . Ann Intern Med 1982;97:503-508.Crossref 29. Winston DJ, Dudnick DV, Chapin M, et al: Coagulase-negative staphylococcal bacteremia in patients receiving immunosuppressive therapy . Arch Intern Med 1983;143:32-36.Crossref 30. Bauer AW, Kirby WMM, Sherris JC, et al: Antibiotic susceptibility testing by a standardized single disc method . Am J Clin Pathol 1966;43:493-498. 31. Gavin TL, Barry AL: Microdilution test procedures , in Lennette EH (ed): Manual of Clinical Microbiology . Washington, DC, American Society for Microbiology, 1980, pp 459-462. 32. Abrahm JL, Mullen JL: A prospective study of prolonged central venous access in leukemia . JAMA 1982;248:2868-2872.Crossref 33. Thomas JH, MacArthur RI, Pierce GI, et al: Hickman-Broviac catheters . Am J Surg 1980;140:791-796.Crossref 34. Starke ID, Donnelly P, Catovsky D, et al: Co-trimoxazole alone for prevention of bacterial infection in patients with acute leukemia . Lancet 1982;1:5-6.Crossref 35. Archer GL, Tenenbaum MJ, Haywood HB: Rifampin therapy of Staphylococcus epidermidis . JAMA 1980;240:751-753.Crossref 36. Archer GL: Antimicrobial susceptibility and selection of resistance among Staphylococcus epidermidis isolates recovered from patients with infections of indwelling foreign devices . Antimicrob Agents Chemother 1978; 14:353-359.Crossref 37. Schaad UB, McCracken GH: Pharmacology and efficacy of vancomycin for staphylococcal infections in children . Rev Infect Dis 1981;3( (suppl) ):282-288.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Aug 1, 1984

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