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Susceptibility to Teicoplanin among Coagulase-Negative Staphylococci Isolated from Catheter Related Bloodstream Infections in Febrile Neutropenic Patients

Author(s): Özlem Güzel-Tunçcan | Derya Tozlu-Keten | Murat Dizbay | Esin Şenol

Journal: Klimik Journal
ISSN 1301-143X

Volume: 23;
Issue: 02;
Start page: 44;
Date: 2010;
Original page

Keywords: Febrile neutropenia | catheter related bloodstream infection | coagulase-negative staphylococci | teicoplanin.

Objective: Catheter related bloodstream infections (CRBSI) caused by coagulase-negative staphylococci (CNS) are frequent in patients with febrile neutropenia (FN) and glycopeptides are used empirically in the treatment of these infections. Recently, decreased susceptibility to teicoplanin among CNS has been reported, especially in Staphylococcus haemolyticus and S. epidermidis, due to excessive use of glycopeptides. In this study, we aimed to determine the minimal inhibitor concentrations (MICs) of teicoplanin and to compare its activity with other antibiotics on CNS isolated from CRBSI in patients with hematological malignancies and hematopoietic stem cell transplantation.Methods: The study was performed on CNS strains isolated from CRBSI of FN patients during the period between 2007 and 2009. Susceptibility to oxacillin was tested by disk diffusion method, and teicoplanin MICs were determined by using E-test® method.Results: A total of 96 CNS strains causing CRBSI, isolated from different FN attacks of 39 patients were analyzed. Among them, S. epidermidis (46%) and S. haemolyticus (39%) were the most frequent CNS species. Although teicoplanin resistance was not detected in the CNS isolates, 10% of the isolates revealed decreased susceptibility to teicoplanin. Teicoplanin MICs and methicillin resistance rates were found to be statistically higher among S. haemolyticus strains than those of S. epidermidis. Conclusions: CNS isolated from CRBSI in FN patients should be identified to the species level, and the change of therapy in case of clinical failure should be made according to the MICs of antibiotics. Teicoplanin MICs among CNS, especially in S. haemolyticus, should be closely monitored.
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