Staphylococcus aureus bacteremia in patients with hematological malignancies and/or agranulocytosis

Acta Med Scand. 1987;222(5):465-70. doi: 10.1111/j.0954-6820.1987.tb10966.x.

Abstract

A total of 6,253 cases of Staphylococcus aureus bacteremia, including 274 (4.4%) endocarditis cases, were registered in Denmark in the period 1975-1984. Patients with hematological malignancies and/or agranulocytosis accounted for 479 of the bacteremia cases. The incidence of endocarditis in this group of patients was only 0.4% as compared to 4.7% in other patients with staphylococcal bacteremia (p less than 0.01). The lower incidence of endocarditis complicating bacteremia in these patients may justify a shorter course of therapy than usually recommended for suspected endocarditis. Patients with hematological malignancies and other patients with agranulocytosis had a higher mortality (49 and 46%, respectively) than other patients with S. aureus bacteremia (33%). The highest mortality was found in patients with multiple myeloma (71%, p less than 0.01), the lowest in patients with acute lymphocytic leukemia (28%, p less than 0.01). The higher mortality in these patients may indicate that empiric antibiotic regimens in granulocytopenic patients should include a specific anti-staphylococcal agent.

MeSH terms

  • Aged
  • Agranulocytosis / microbiology*
  • Endocarditis, Bacterial / etiology
  • Female
  • Humans
  • Leukemia / microbiology*
  • Lymphoma / microbiology*
  • Male
  • Polycythemia Vera / microbiology
  • Sepsis / etiology*
  • Sepsis / immunology
  • Sepsis / mortality
  • Staphylococcal Infections / etiology*
  • Staphylococcal Infections / immunology
  • Staphylococcal Infections / mortality
  • Waldenstrom Macroglobulinemia / microbiology