MRSA Research Today is a free monthly online journal that collates and summarizes the latest research about MRSA, including details on methicillin-resistant staphylococcus aureus, hospitals, infection, antibiotic resistance, superbugs.

Emergence of MRSA in positive blood cultures from patients with febrile neutropenia-a cause for concern.

Morris PG, Hassan T, McNamara M, Hassan A, Wiig R, Grogan L, Breathnach OS, Smyth E, Humphreys H

Department of Oncology, Beaumont Hospital, Dublin 9, Dublin, Ireland, p_ob1_morris@yahoo.com.

GOALS OF WORK: Febrile neutropenia (FN) causes considerable morbidity in patients on cytotoxic chemotherapy. Recently, there has been a trend towards fewer Gram-negative and more Gram-positive infections with increasing antibiotic resistance. To assess these patterns, data from a supra-regional cancer centre in Ireland were reviewed. PATIENTS AND METHODS: A 5-year review of all positive blood cultures in patients undergoing anti-cancer chemotherapy was carried out. MAIN RESULTS: Eight hundred and ninety-four patients were reviewed. The mean incidence of FN was 64.2 cases per year. Eight hundred and forty-six blood culture specimens were taken and 173 (20.4%) were culture positive. The isolated organisms were Gram positive (71.1%), Gram negative (27.8%) and fungal (1.1%). Of the Gram-positive organisms, 75.6% were staphylococci. Of these, 67.8% were coagulase-negative staphylococci and 30.1% were Staphylococci aureus. Amongst the S. aureus, 89.3% were methicillin-resistant (MRSA). Vancomycin-resistant enterococci were not identified as a cause of positive blood cultures. CONCLUSIONS: Amongst patients with cancer who develop FN in our hospital, Gram-positive bacteria account for the largest proportion. The high proportion of MRSA as a cause of positive blood cultures is of concern.

Published 15 February 2008 in Support Care Cancer.
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