Abstract
A significant increase in the use of vascular access devices has changed the spectrum of organisms causing bacteremia and fungemia at Memorial Sloan-Kettering Cancer Center. This paper documents the 1988 laboratory experience with bacteremia and fungemia and contrasts some of that data with information obtained in 1984. In 1988, 439 tunnelled-catheters and 355 ports were inserted in patients; 2,778 organisms were subsequently recovered from 933 episodes of bacteremia and fungemia. Fifty-percent of the episodes of bacteremia and fungemia were vascular access device-related. Compared to 1984, the relative incidence of bacteremia due to gram-positive organisms increased from 33 to 43 %, polymicrobic cultures increased from 24 to 27 %, and the number of organisms with colony counts greater than 100 cfu/ml increased from 24 to 44 %. In 1988, device-related sepsis was often caused byAcinetobacter spp.,Bacillus spp.,Corynebacterium spp., pseudomonads other thanPseudomonas aeruginosa, and coagulase-negative staphylococci. Infection was also caused by species of flavobacteria,Micrococcus, andRhodotorula. Efforts required for identification of many of the newer pathogens have escalated material and personnel costs.
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Kiehn TE: Bacteremia and fungemia in the immunocompromised patient. European Journal of Clinical Microbiology and Infectious Diseases 1989, 8: 832–837.
Raucher HS, Hyatt AC, Barzilai A, Harris MB, Weiner MA, LeLeiko NS, Hodes DS: Quantitative blood cultures in the evaluation of septicemia in children with Broviac catheters. Journal of Pediatrics 1984, 104: 29–33.
Wing EJ, Norden CW, Shadduck RK, Winkelstein A: Use of quantitative bacteriologic techniques to diagnose catheter-related sepsis. Archives of Internal Medicine 1979, 139: 482–483.
Mosca R, Curtas S, Forbes B, Mequid MM: The benefits of Isolator cultures in the management of suspected catheter sepsis. Surgery 1987, 102: 718–723.
Whimbey E, Wong B, Kiehn TE, Armstrong D: Clinical correlations of serial quantitative blood cultures determined by lysis-centrifugation in patients with persistent septicemia. Journal of Clinical Microbiology 1984, 19: 766–771.
Benezra D, Kiehn TE, Gold JWM, Brown AE, Turnbull ADM, Armstrong D: Prospective study of infections in indwelling central venous catheters using quantitative blood cultures. American Journal of Medicine 1988, 85: 495–498.
Brannon P, Kiehn TE: Clinical comparison of lysis-centrifugation and radiometric resin systems for blood culture. Journal of Clinical Microbiology 1986, 24: 886–887.
Brannon P, Kiehn TE: Large-scale clinical comparison of the lysis-centrifugation and radiometric systems for blood culture. Journal of Clinical Microbiology 1985, 22: 951–954.
Kiehn TE, Wong B, Edwards FF, Armstrong D: Comparative recovery of bacteria and yeasts from lysis-centrifugation and a conventional blood culture system. Journal of Clinical Microbiology 1983, 18: 300–304.
Singer C, Kaplan MH, Armstrong D: Bacteremia and fungemia complicating neoplastic disease. American Journal of Medicine 1977, 62: 731–742.
Whimbey E, Gold JWM, Polsky B, Dryjanski J, Hawkins C, Blevins A, Brannon P, Kiehn TE, Brown AE, Armstrong D: Bacteremia and fungemia in patients with the acquired immunodeficiency syndrome. Annals of Internal Medicine 1986, 104: 511–514.
Whimbey E, Kiehn TE, Brannon P, Benezra D, Armstrong D: Clinical significance of colony counts in immunocompromised patients withStaphylococcus aureus bacteremia. Journal of Infectious Diseases 1987, 155: 1328–1330.
Lowder JN, Lazarus HM, Herzig RH: Bacteremias and fungemias in oncologic patients with central venous catheters. Archives of Internal Medicine 1982, 142: 1456–1473.
Pizzo PA, Ladisch S, Simon RM, Gill F, Levine AS: Increasing incidence of gram-positive sepsis in cancer patients. Medical Pediatrics and Oncology 1978, 5: 241–244.
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Kiehn, T.E., Armstrong, D. Changes in the spectrum of organisms causing bacteremia and fungemia in immunocompromised patients due to venous access devices. Eur. J. Clin. Microbiol. Infect. Dis. 9, 869–872 (1990). https://doi.org/10.1007/BF01967501
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DOI: https://doi.org/10.1007/BF01967501