Table 3.
Characteristics of blood streams infections in newly diagnosed myeloma patients
| Serial number | BSI after ICT | ICT regimen | Catheter type | Definite CRIb | Pathogen | Empirical antibiotics | Early death (< 100day) |
|---|---|---|---|---|---|---|---|
| Nosocomial BSIa | |||||||
| 1 (90) | - | - | - | - | Coagulase-negative Staphylococcus species | Ceftazidime/isepamicin | Y |
| 2 (215) | Y | Thalidomide/dexamethasone | - | - | Coagulase-negative Staphylococcus species | Ceftazidime | - |
| 3 (79) | Y | VAD | Implanted port | Y |
Coagulase-negative Staphylococcus species
Klebsiella pneumoniae |
Teicoplanin/isepamicin | Y |
| 4 (27) | - | MP | - | - | Klebsiella pneumoniae | Cefepime | - |
| 5 (62) | Y | MPT | Non-tunneled CVC | Y | Klebsiella pneumoniae | Ciprofloxacin - > Imipenem/teicoplanin |
Y |
| 6 (78) | - | - | - | - | Escherichia coli | Y | |
| 7 (198) | Y | VAD | Non-tunneled CVC | - | Escherichia coli | Cefuroxime/clindamycin | Y |
| 8 (168) | Y | VAD/thalidomide | Non-tunneled PICC | - | Escherichia coli | Imipenem/vancomycin/amikin | Y |
| 9 (175) | Y | VAD | - | - | Escherichia coli | Cefuroxime/metronidazole | - |
| 10 (150) | Y | VAD | - | - | Enterobacter gergoviae | Oxacillin | - |
| 11 (14) | Y | VAD | Implanted port | - | Enterobacter cloacae | - | |
| 12 (94) | - | VAD | Non-tunneled CVC | - | Pseudomonas Aeruginosa | Cefepime | Y |
| 13 (115) | Y | VAD | Implanted port | - | Proteus mirabilis | Levofloxacin | - |
| 14 (69) | Y | VAD | - | - | Salmonella Enteritidis group D | Ceftazidime | Y |
| 15 (114) | Y | VAD | Non-tunneled CVC | - | Staphylococcus aureus | - | |
| 16 (71) | - | - | Non-tunneled CVC | Y | Serratia marcescens | Y | |
| 17 (61) | Y | MP | Non-tunneled CVC | - | Yeast like-Trichosporon asahii | Cefepime/azithromycin | Y |
| 18 (18) | Y | VAD | - | - | Yeast like-Candida albicans | Ceftazidime/teicoplanin | Y |
| Non-nosocomial BSI | |||||||
| 1 (221) | - | - | - | - | Coagulase-negative Staphylococcus species | Flomoxef | - |
| 2 (41) | Y | VAD | - | - | Coagulase-negative Staphylococcus species | Piperacillin/tazobactam | - |
| 3 (211) | Y | MP | - | - | Coagulase-negative Staphylococcus species | - | |
| 4 (205) | - | - | - | - | Streptococcus | Meropenem/vancomycin/metronidazole | Y |
| 5 (137) | - | - | - | - | Streptococcus pneumoniae | - | |
| 6 (6) | - | MP | - | - | Escherichia coli | Cephalexin/isepamicin | - |
| 7 (106) | - | VAD | Non-tunneled CVC | - | Pseudomonas aeruginosa | Cefoperazone | - |
| 8 (46) | Y | MP | Tunneled CVC (Permcath) |
- | Lactobacillus species | Moxifloxacin | Y |
Abbreviations: BSI Blood stream infection, ICT Induction chemotherapy, CRI Catheter related infection, VAD Vincristine/doxorubicin/dexamethasone, MP Melphalan/prednisolone, MPT Melphalan/prednisolone/thalidomide, CVC Central venous catheter, PICC Peripherally inserted central catheter
aNosocomial infection is defined as infection become evident 48 h or more after admission
bDefinite CRI (catheter related infection) is defined as bacteremia/fungemia in a patient with an intravascular catheter with at least one positive blood culture obtained from a peripheral vein, clinical manifestations of infection (i.e., fever, chills, and/or hypotension), and no apparent source for the bloodstream infection except the catheter