Long-term epidemiology of bacterial susceptibility profiles in adults suffering from febrile neutropenia with hematologic malignancy after antibiotic change

Figures & data

Figure 1 Gram-classification of the isolated bacteria in all cultures (1994–2008).

Figure 2 Isolated Gram-positive bacteria in all cultures (1994–2008).

Abbreviations: MRSA, Methicillin-resistant S. Aureus; MSSA, Methicillin-sensitive S. Aureus; CNS oxa R, CNS oxacillin-resistant; CNS oxa S, CNS oxacillin-sensitive.

Figure 3 Isolated Gram-negative bacteria in all cultures (1994–2008).

Figure 4 Characteristics of the isolated bacteria (1994–2008).

Abbrevations: CNA, coagulase-negative Staphylococci; CNS oxa-R, CNS oxacillin-resistant; CNS oxa-S, CNS oxacillin-sensitive; MSSA, methicillin-sensitive S. aureus; MRSA, methicillin-resistant S. aureus.

Table 1 Behavior of antimicrobial sensitivity of Gram-positive bacteria isolated in the period 1994–2008

	1994	1995	1996	1997	1998	1999	2000	2001	2002	2003	2004	2005	2006	2007	2008
MSSA, all cultures
n	24	16	18	19	12	10	14	14	12	17	11	14	10	12	11
Penicillin	83.8	87.5	88.9	89.5	100	90.0	85.7	78.6	91.7	88.2	90.0	91.7	66.7	100	90.9
Oxacillin	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Amikacin	0	0	5.6	5.3	0	0	0	0	0	0	0	0	0	0	0
Cotrimoxazole	0	0	11.1	5.3	0	0	14.3	0	0	0	0	0	0	0	0
Ciprofloxacin	–	12.5	33.3	15.8	0	0	0	0	8.3	0	–	–	0	0	0
Vancomycin	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Teicoplanin	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
CNS, oxacillin-sensitive, all cultures
n	56	48	52	27	45	36	23	32	22	27	30	25	31	26	42
Penicillin	66.1	79.2	73.1	74.1	48.9	66.7	60.9	53.1	50.0	55.6	56.7	56	66.7	80.8	73.8
Amoxy-Clav	0	2.1	7.7	0	2.2	2.8	4.3	0	0	–	–	–	–	–	–
Oxacillin	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Meropenem	–	–	–	–	2.2	0	4.3	0	0	–	–	–	–	–	–
Cefepime	–	12.5	7.7	3.7	2.3	8.3	4.3	0	0	–	–	–	–	–	–
Amikacin	0	0	3.8	0	2.2	0	4.3	0	0	0	0	0	3.2	0	0
Cotrimoxazole	17.9	18.8	11.5	11.1	13.3	16.7	13.0	3.1	0	3.7	16.7	24.0	22.6	23.1	26.2
Ciprofloxacin	–	29.2	15.4	11.1	15.6	11.1	17.4	3.1	27.3	16.7	–	–	50.0	53.8	42.9
Vancomycin	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Teicoplanin	0	2.1	0	0	0	0	0	0	0	0	0	0	3.2	0	0
CNS, oxacillin-sensitive, blood cultures
n	47	35	38	27	39	30	20	29	16	22	20	17	22	16	26
Penicillin	68.1	77.1	76.3	74.1	48.7	63.3	65.0	51.7	43.8	59.1	55.0	47.1	71.4	87.5	84.6
Amoxy-Clav	0	2.9	5.3	0	2.6	3.3	5	0	0	–	–	–	–	–	–
Oxacillin	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Meropenem	–	–	–	–	2.6	0	0	0	0	–	–	–	–	–	–
Cefepime	–	10.0	5.3	3.7	2.6	10.0	0	0	0	–	–	–	–	–	–
Amikacin	0	0	5.3	0	2.6	0	0	0	0	0	0	0	4.5	0	–
Cotrimoxazole	8.3	7.7	15.8	11.1	12.8	16.7	0	3.4	0	4.5	20.0	17.6	22.7	37.5	30.8
Ciprofloxacin	–	15.4	21.1	11.1	15.4	13.3	0	3.4	0	20.0	0	–	50.0	68.8	50.0
Vancomycin	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Teicoplanin	0	0	0	0	0	0	0	0	0	0	0	0	4.5	0	0
Levofloxacin
CNS, oxacillin-resistant, all cultures
n	93	80	84	105	65	58	49	84	56	66	75	82	103	73	80
Penicillin	100	97.4	100	99.0	100	100	100	96.4	100	100	98.7	96.9	98.6	94.7	98
Amoxy-Clav	40.0	71.4	71.4	73.3	67.7	67.2	69.4	61.9	91.1	–	–	–	–	–	–
Oxacillin	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100
Meropenem	–	–	–	–	50.8	63.8	63.3	60.7	28.6	–	–	–	–	–	–
Cefepime	–	71.4	59.5	53.3	53.8	60.3	57.1	73.8	63.6	–	–	–	–	–	–
Amikacin	6.7	28.8	29.8	24.8	29.2	27.6	46.9	28.6	32.1	27.3	29.7	23.2	24.5	17.8	–
Cotrimoxazole	53.3	60.0	67.9	79.0	64.6	56.9	71.4	44.0	51.2	74.3	78.7	70.7	69.6	61.1	70.0
Ciprofloxacin	–	77.5	70.2	85.7	80.0	75.9	87.7	65.5	83.9	72.7	0	–	75.0	85.7	89.8
Vancomycin	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Teicoplanin	0	0	0	1.0	1.5	1.7	4.1	1.2	1.8	4.5	1.3	2.4	0	1.4	1.3
CNS, oxacillin-resistant, blood cultures
n	89	71	79	91	61	48	45	75	47	62	59	71	81	57	58
Penicillin	100	97.1	100	98.9	100	100	100	96.0	100	100	98.3	96.5	98.5	93.3	100
Amoxy-Clav	30.8	76.5	72.2	73.6	67.2	64.6	75.6	64.0	89.4	–	–	–	–	–	–
Oxacillin	100	100	100	100	100	100	100	100	100	100	100	100	100	100	100
Meropenem	–	–	–	–	52.5	62.5	66.7	62.7	32	–	–	–	–	–	–
Cefepime	–	77.8	60.8	52.7	52.5	58.3	62.2	72.0	61.9	–	–	–	–	–	–
Amikacin	0	29.6	30.4	24.2	29.5	27.1	51.1	32.0	31.8	29.0	28.8	19.7	22.2	22.9	–
Cotrimoxazole	46.2	57.7	68.4	81.3	62.3	62.5	75.6	44.0	51.0	74.2	76.3	70.4	67.9	69.6	60.3
Ciprofloxacin	–	74.6	68.4	84.6	78.7	75.0	88.9	64.0	83.1	72.7	–	-	66.7	88.9	90.0
Vancomycin	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
Teicoplanin	0	0	0	1.1	1.6	2.1	4.4	1.3	2.1	4.8	0	2.8	0	1.8	1.7
Levofloxacin	–	–	–	–	–	–	–	–	–	78.3	83.7	82.7	76.7	–	–

Notes: n, number of isolates; –, not tested; Shown results indicate decreased sensitivity.

Abbreviations: CNS, Coagulase-negative Staphylococci; MRSA, Methicillin-resistant S. aureus; MSSA, Methicillin-sensitive S. aureus.

Table 2 Behavior of antimicrobial sensitivity of Gram-negative bacteria isolated in the period 1994–2008

	1994	1995	1996	1997	1998	1999	2000	2001	2002	2003	2004	2005	2006	2007	2008
E. coli, all cultures
n	74	72	55	93	64	61	38	44	39	57	53	59	63	69	69
Ampicillin	60.8	59.7	52.7	72.0	53.1	63.9	55.3	65.9	61.5	33.3	58.5	62.1	63.5	60.3	70.1
Amoxy-clav	5.4	16.7	3.6	11.8	7.8	14.8	15.8	0	0	3.5	9.4	6.8	7.9	17.4	13.4
Piperacillin	40.5	40.3	41.8	61.3	37.5	45.9	36.8	56.8	46.2	63.8	53.9	–	–	–	–
Ceftazidime	5.4	4.2	0	4.3	0	13.1	5.3	0	2.6	5.3	3.8	1.7	0	3.2	14
Cefepime	2.7	0	0	0	0	11.5	0	0	2.6	3.5	0	0	0	1.6	7.3
Meropenem	–	–	–	–	0	1.6	0	0	0	0	0	0	0	0	0
Imipenem	0	0	0	0	–	–	–	–	–	–	–	–	–	–	–
Amikacin	1.4	0	0	0	0	1.6	0	0	0	0	1.9	0	1.6	0	1.4
Ciprofloxacin	31.5	35.2	29.1	38.7	26.6	42.6	28.9	36.4	38.5	26.1	–		9.1	49.3	40.6
Cotrimoxazole	44.6	40.3	49.1	53.8	40.6	57.4	39.5	47.7	48.7	35.1	34.0	51.7	52.4	56.5	50.7
Non-inducible Enterobacteriaceae, all cultures
n	16	15	25	27	28	22	11	12	7	11	24	13	19	19	13
Ampicillin	68.8	80	80	70.4	78.6	68.2	90.9	75	85.7	54.6	75.0	84.6	78.9	81.3	69.2
Amoxy-clav	12.5	26.7	16.0	7.4	3.6	9.1	0	8.3	14.3	0	16.7	30.8	5.3	26.3	16.7
Piperacillin	31.3	33.3	20.0	29.6	35.7	27.3	36.4	33.3	14.3	9.1	20.8	–	–	–	–
Ceftazidime	25.0	6.7	12.0	9.0	17.9	9.1	9.1	0	0	0	0	7.7	0	0	0
Cefepime	6.7	9.1	0	0	3.6	4.5	0	8.3	0	0	0	7.7	0	0	0
Meropenem	–	–	–	–	0	0	0	0	0	0	0	0	5.3	5.3	0
Imipenem	0	6.7	0	0	–	–	–	–	–	–	–	–	–	–	–
Amikacin	0	6.7	0	0	0	4.5	0	0	0	0	0	7.7	5.3	5.3	0
Ciprofloxacin	12.5	0	0	38.7	10.7	4.5	36.4	25.0	14.3	0	–	–	0	10.5	7.7
Cotrimoxazole	12.5	6.7	12.0	30.0	28.6	13.6	45.5	33.3	14.3	9.1	16.7	7.7	15.8	15.8	23.1
Inducible Enterobacteriaceae, all cultures
n	36	37	26	20	26	15	12	18	10	16	16	17	22	16	19
Ampicillin	94.4	80.6	84.6	85.0	72.7	73.3	83.3	88.9	80.0	100	81.3	94.1	95.5	93.8	78.9
Amoxy-clav	88.9	75.0	84.6	85.0	72.7	86.7	66.7	77.8	80.0	68.8	62.5	88.2	81.8	87.5	57.9
Piperacillin	72.2	48.6	30.8	15.0	36.4	13.3	16.7	22.2	10.0	75.1	37.5	–	–	–	–
Ceftazidime	75.0	35.1	30.8	15.0	31.8	13.3	8.3	11.1	10.0	62.8	37.5	47.1	36.4	37.5	35.5
Cefepime	13.9	0	7.7	0	0	0	0	0	0	12.5	0	17.6	4.5	12.5	12.5
Meropenem	–	–	–	–	4.6	0	0	0	0	0	0	5.9	0	0	0
Imipenem	0	0	0	5.0	–	–	–	–	–	–	–	–	–	–	–
Amikacin	36.1	18.9	0	5.0	18.2	6.7	0	0	0	18.8	6.3	11.8	13.6	0	15.8
Ciprofloxacin	52.8	24.3	15.4	10.0	31.8	6.7	33.3	5.6	10.0	60.0	-		33.3	25.0	33.3
Cotrimoxazole	52.8	33.3	11.5	10.0	40.9	6.7	0	5.6	10.0	50.0	31.3	35.3	22.7	31.3	47.4
Pseudomonas aeruginosa, all cultures
n	15	7	13	14	11	8	3	10	6	8	10	5	14	7	9
Piperacillin	0	14.3	0	14.3	18.2	12.5	–	0	0	12.5	10.0	–	–	–	–
Ceftazidime	0	0	0	0	9.1	12.5	–	0	0	12.5	20.0	0	28.6	14.3	11.1
Cefepime	53.3	25.0	0	14.3	9.1	12.5	–	0	0	25.0	10.0	20.0	21.4	14.3	11.1
Imipenem	0	14.3	15.4	21.4	–	–	–	–	–	–	–	–	–	–	–
Meropenem	–	–	–	–	18.2	0	–	0	0	25.0	10.0	20.0	7.1	14.3	33.3
Amikacin	0	0	0	7.1	0	0	–	0	0	25.0	10.0	0	7.1	0	11.1
Ciprofloxacin	6.7	16.7	0	7.1	18.2	0	–	0	0	0	–	–	100	14.3	22.2

Notes: n, number of isolates; –, not tested; Shown results indicate decreased sensitivity.

Figure 5 Antibiotic consumption in the hematology ward (1994–2008).

Abbrevation: DDD, defined daily doses.