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Table 4 Comparison between patients with viridans streptococcal bacteremia susceptible to cefepime and those not susceptible to cefepime

From: Clinical characteristics and antimicrobial susceptibilities of viridans streptococcal bacteremia during febrile neutropenia in patients with hematologic malignancies: a comparison between adults and children

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
  1. Data are median (inter quartile range), mean ± SD, or No. (%) of cases.
  2. VSB viridans streptococcal bacteremia.
  3. *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.
  4. †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).
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