Table 4.
Comparison between patients with viridans streptococcal bacteremia susceptible to cefepime and those not susceptible to cefepime
| Factor | Susceptible to cefepime (n=159) | Not susceptible to cefepime (n=40) | p-value |
|---|---|---|---|
| Age (years) |
38 (20-51) |
17 (2-51) |
0.013 |
| Gender (male) |
89 (56.0) |
19 (47.5) |
0.456 |
| Underlying disease |
|
|
0.320 |
| Acute myeloid leukemia |
117 (73.6) |
28 (70.0) |
|
| Acute lymphoblastic leukemia |
26 (16.4) |
9 (22.5) |
|
| Other leukemias |
6 (3.1) |
1 (2.5) |
|
| Non-Hodgkin lymphoma |
8 (5.0) |
1 (2.5) |
|
| Multiple myeloma |
2 (1.3) |
1 (2.5) |
|
| Complete remission status |
104 (65.4) |
19 (47.5) |
0.037 |
| Preceding therapy |
|
|
0.732 |
| Conventional chemotherapy |
151 (95.0) |
38 (95.0) |
|
| Hematopoietic cell transplantation |
|
|
|
| Autologous |
6 (3.8) |
2 (5.0) |
|
| Allogeneic |
2 (1.3) |
0 (0.0) |
|
| Duration after the preceding therapy (days) |
12 (10-14) |
13 (10-13) |
0.568 |
| Antibacterial prophylaxis* |
|
|
<0.001 |
| None |
4 (2.5) |
1 (2.7) |
|
| Trimethoprim/sulfamethoxazole |
31 (19.5) |
20 (54.1) |
|
| Ciprofloxacin |
124 (78.0) |
16 (43.2) |
|
| Probability of antibacterial therapy after chemotherapy† (%) |
84.0 ± 29.6 |
81.8 ± 32.0 |
0.864 |
| Previous antibacterial therapy for febrile neutropenia† (times) |
1 (1-2) |
2 (1-2) |
0.284 |
| Accompanying symptoms |
|
|
|
| Oral mucositis |
35 (22.0) |
6 (15.0) |
0.327 |
| Cough |
18 (11.3) |
2 (5.0) |
0.377 |
| Sputum |
6 (3.8) |
3 (7.5) |
0.388 |
| Rhinorrhea |
1 (0.6) |
0 (0.0) |
1.000 |
| Diarrhea |
50 (31.4) |
8 (20.0) |
0.154 |
| Abdominal pain |
34 (21.4) |
4 (10.0) |
0.102 |
| Polymicrobial infection |
|
|
|
| Other bacterial infection |
17 (10.7) |
5 (12.5) |
0.779 |
| Fungal infection |
16 (10.1) |
2 (5.0) |
0.537 |
| Complications attributable to VSB |
23 (14.5) |
3 (7.5) |
0.243 |
| Ventilator care |
8 (5.0) |
0 (0.0) |
0.362 |
| Acute respiratory distress syndrome |
6 (3.8) |
0 (0.0) |
0.602 |
| Shock |
23 (14.5) |
3 (7.5) |
0.243 |
| Death |
4 (2.5) |
0 (0.0) |
0.585 |
| Overall death |
13 (8.2) |
1 (2.5) |
0.309 |
| Laboratory findings |
|
|
|
| White blood cell count (/μL) |
60 (20-160) |
40 (20-118) |
0.194 |
| Absolute neutrophil count (/μL) |
0 (0-0) |
0 (0-0) |
0.915 |
| Duration of neutropenia before the diagnosis of VSB (days) |
5 (4-7) |
7 (5-11) |
0.021 |
| Total duration of neutropenia (days) |
16 (12-23) |
20 (12-24) |
0.094 |
| Peak C-reactive protein level (mg/dL) | 19.6 (13.1-26.1) | 17.1 (9.3-28.1) | 0.397 |
Data are median (inter quartile range), mean ± SD, or No. (%) of cases.
VSB viridans streptococcal bacteremia.
*Antibacterial prophylaxis was evaluated in 196 patients (159 with viridans streptococcal bacteremia susceptible to cefepime, 37 with viridans streptococcal bacteremia not susceptible to cefepime) except 3 patients who had been undergoing ceftazidime treatment and 3 patients in whom cefepime susceptibility tests were not done.
†Information on previous chemotherapies and antibacterial therapies was completely reviewed in 166 patients (137 with viridans streptococcal bacteremia susceptible to cefepime, 29 with viridans streptococcal bacteremia not susceptible to cefepime).