Sterilization Of Catheters Using Providone-Iodine Decreases The Incidence Of Catheter-Associated Bloodstream Infection

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2984-2984
Author(s):  
Minako Sugiyama ◽  
Yukayo Terashita ◽  
Junjiro Ohshima ◽  
Tomonobu Sato ◽  
Yuko Cho ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Bacterial Infections ◽  
Hematological Malignancies ◽  
Povidone Iodine ◽  
Blood Cultures ◽  
Access Port ◽  
Gram Negative ◽  
Immune Deficiencies ◽  
Definition Of ◽  
Second Period

Abstract Introduction The use of central venous (CV) catheters is crucial for administering chemotherapy to children; however, catheter-related bacterial infections can be life threatening. The guidelines of Centers for Disease Control (CDC) and Prevention recommend ensuring sterile access to CV catheters by scrubbing the access port with an appropriate antiseptic, such as chlorhexidine, povidone-iodine, or 70% alcohol, and accessing the port only with sterile devices. For pediatric patients receiving chemotherapy, our institution uses the Hickman catheter as a CV catheter. Between April 2008 and March 2010, 83% alcohol was used to sterilize the access port. Because a large number of patients acquired subsequent infections including with Bacillus cereus, we used 10% povidone-iodine before accessing the catheter between April 2010 and March 2012. We compared the rates of bacterial infections during these two periods. Patients and Methods We performed blood cultures of patients receiving chemotherapy using venous puncture or a CV catheter before starting antibiotics. We determined the number of positive cultures, identified the infectious agent, and clinically evaluated the infected patients. Between April 2008 and March 2010, we investigated297 patients, of which 207 were treated using CV catheters. The median age of the 207 patients (129 males and 78 females) was 8 years (range, 2 months to 30 years). The indications for chemotherapy included stem-cell transplantation to treat the diseases as follows: hematological malignancies (n=127), malignant solid tumors (n=62), and congenital immune deficiencies (n=18). Between April 2010 and March 2012, we investigated 291 patients, of which 185 were treated using CV catheters. The median age of the 185 patients (129 males and 56 females) was 6 years (range, 10 months to 16 years). The indications for chemotherapy included the following conditions: hematological malignancies (n=98), malignant solid tumors (n=81), pure red-cell aplasia (n=4), and congenital immune deficiencies (n=2). We defined catheter-associated bloodstream infection by detection of common commensal pathogens, such as Staphylococcus species and Bacillus cereus, according to the definitions of the CDC/NHSN along with detection of pathogens from cultures collected from the access port of the CV catheter. Results There was no significant difference between the two groups in patient characteristics such as median age and the period of neutropenia. The frequency of positive blood cultures were 16.4% (34/207) and 11.9% (22/185) (p = 0.224) for the former and latter periods, respectively. In the first period, 61.8% (21/34) of the pathogens isolated were gram-positive (e.g., S. epidermidis) and 41.2% (14/34) were gram-negative (e.g., B cereus). Our definition of catheter-associated bloodstream infection was met by 12.6% (26/207) in these cases. In the second period, 40.9% (9/22) of the pathogens isolated were gram-positive and 40.9% (9/23) were gram-negative (e.g., Enterobacter cloacae). Our definition of catheter-associated bloodstream infection was met by 6.5% (12/185) (p = 0.0658) Notably, B. cereus was not detected in the second period. Conclusion Sterilization of the access port of CV catheters using povidone-iodine decreased catheter-associated bloodstream infection. A significant advantage of using povidone-iodine was eliminating infections with the fatal pathogen, B. cereus. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Impact of follow up blood cultures on outcomes of patients with community-onset gram-negative bloodstream infection

2021 ◽  
Vol 34 ◽  
pp. 100811
Author(s):  
Rajiv Amipara ◽  
Hana Rac Winders ◽  
Julie Ann Justo ◽  
P. Brandon Bookstaver ◽  
Joseph Kohn ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Blood Cultures ◽  
Gram Negative ◽  
Community Onset

Serum biomarkers to differentiate Gram-negative, Gram-positive and fungal infection in febrile patients

2021 ◽  
Vol 70 (7) ◽  
Author(s):  
Dongguang Niu ◽  
Qian Huang ◽  
Fan Yang ◽  
Weiliang Tian ◽  
Chen Li ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Serum Levels ◽  
Serum Biomarker ◽  
Diagnostic Efficiency ◽  
Gram Positive ◽  
Gram Negative ◽  
Neutrophil Lymphocyte Ratio ◽  
Bacteria And Fungi

Introduction. Contamination of specimens and overuse of broad spectrum antibiotics contribute to false positives and false negatives, respectively. Therefore, useful and applicable biomarkers of bacteremia are still required. Hypothesis/Gap Statement. IL-6 can be used as a serum biomarker to discriminate among bacterial infections and fungal infections in febrile patients with a bloodstream infection. Aim. We aimed to evaluate the diagnostic efficiency of neutrophil/lymphocyte ratio (NLR), procalcitonin (PCT) and interleukin-6 (IL-6) in discriminating Gram-negative (G−) bacteria from Gram-positive (G+) bacteria and fungi in febrile patients. Methodology. A total of 567 patients with fever were evaluated. Serum levels of IL-6, PCT, NLR and CRP were compared among a G− group (n=188), a G+ group (n=168), a fungal group (n=38) and a culture negative group (n=173). Sensitivity, specificity, Yuden’s index and area under the Receiver operating characteristic (ROC) curve (AUC) were obtained to analyse the diagnostic abilities of these biomarkers in discriminating bloodstream infection caused by different pathogens. Results. Serum IL-6 and PCT in the G− group increased significantly when compared with both the G+ group and fungal group (P <0.05). AUC of IL-6 (0.767, 95 % CI:0.725–0.805) is higher than AUC of PCT (0.751, 95 % CI:0.708–0.796) in discriminating the G− group from G+ group. When discriminating the G− group from fungal group, the AUC of IL-6 (0.695, 95 % CI:0.651–0.747) with a cut-off value of 464.3 pg ml−1 was also higher than the AUC of PCT (0.630, 95 % CI:0.585–0.688) with a cut-off value of 0.68 ng ml−1. Additionally, AUC of NLR (0.685, 95 % CI:0.646–0.727) in discriminating the fungal group from G+ group at the cut-off value of 9.03, was higher than AUC of IL-6, PCT and CRP. Conclusion. This study suggests that IL-6 could be used as a serum biomarker to discriminate among bacterial infections and fungal infections in febrile patients with a bloodstream infection. In addition, NLR is valuable to discriminate fungal infections from Gram-positive infections in febrile patients with a bloodstream infection.

Early Quantitative Determination of Serum Procalcitonin Can Help Distinguishing Strains of Different Bloodstream Infections in Patients with Hematologic Diseases

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3703-3703
Author(s):  
Xiaofeng Luo ◽  
Jinhua Ren ◽  
Zhizhe Chen ◽  
Ting Yang ◽  
Jianda Hu
Keyword(s):  
Quantitative Determination ◽  
Bloodstream Infection ◽  
Large Population ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Hematologic Diseases ◽  
Fungi Infection

Abstract High procalcitonin (PCT) levels are strongly associated with systemic bacterial infections. PCT is produced in response to bacterial endotoxin and inflammatory cytokines. Few studies are available in the literature on PCT ability to distinguish different strains of bloodstream infections in patients with hematologic diseases. The aim of the present study was to explore the value of determining serum PCT values early, i.e., as soon as blood cultures are positive, in a large population of patients with hematologic diseases. Patients with hematologic diseases admitted to the hematology department of our hospitalfrom January 2013 to March 2016 who had bloodstream infections were retrospectively analyzed. Patients whose blood samples were collected for simultaneous blood culture and PCT test were enrolled in the study, and they were divided into agranulocytosis and non-agranulocytosis groups. Automatic microbial analyzer was used to identify all strains, and PCT levels were analyzed with an automatic electrochemiluminescence system. The relationship between PCT levels and the strains in bloodstream infections was analyzed and compared, and the diagnostic efficacy of PCT was evaluated using the receiver operating characteristic (ROC) curve. A total of 494 bloodstream infection cases that fulfilled the inclusion criteria were included in the study, involving 312 cases of bloodstream infection with single Gram-negative, 146 cases with single Gram-positive, 12 cases with single fungi, 19 cases with polymicrobes, and 5 cases identified as contaminated specimens. Unpaired t-test was used for data analysis. PCT levels for single Gram-negative infection (15.17±2.11 ng/ml) were significantly higher than those for Gram-positive infection (3.30 ± 0.93 ng/ml) (P<0.0001), or those for single fungi infection (0.22 ± 0.04 ng/ml) (P<0.0001). PCT levels for single Gram-positive infection were also significantly higher than those in single fungi infection (P<0.01). In the agranulocytosis group, which included 403 cases, the PCT levels in the single Gram-negative infection (14.14 ± 2.13 ng/ml) were significantly higher than those in single Gram-positive (2.49 ± 0.73 ng/ml) (P<0.0001), or in single fungi infection (0.24 ± 0.04 ng/ml) (P<0.0001). The PCT levels in the single Gram-positive bacterial infection were also significantly higher than those in single fungi infection (P<0.01). In the single Gram-negative bacteria bloodstream infection, we further found that the PCT levels in Enterobacteriaceae infection (17.00 ± 3.04 ng/ml) were significantly higher than those in nonfermentative Gram-negatives infection (6.49 ± 1.50 ng/ml) (P<0.01). ROC analysis was performed on monomicrobial blood cultures. ROC of single Gram-negative and Gram-positive infections revealed that the area under the curve (AUC) was 0.687, the best cut-off value was 0.58 ng/ml, the sensitivity was 60.81% and specificity was 71%. ROC of single Gram-negative and fungi infections revealed that the AUC was 0.795, the best cut-off value was 0.42 ng/ml, the sensitivity was 67% and specificity was 100%. ROC of single Gram-positive and fungi infections revealed that the AUC was 0.6, the best cut-off value was 0.44 ng/ml, the sensitivity was 37% and specificity was 100%. In the non-agranulocytosis group, we only found that the PCT levels in the single Gram-negative infection were significantly higher than those in single Gram-positive infection (P<0.05). In summary, early serum PCT quantitative determination can be used as a routine test to help to distinguish Gram-negative bacteria, Gram-positive bacteria, or fungi bloodstream infections in patients with hematologic diseases. These findings will be of great clinical value to select appropriate antibiotics for patients with hematologic diseases and bloodstream infections. Figure Figure. Disclosures No relevant conflicts of interest to declare.

scholarly journals Epidemiology, resistant pathogens and main causes of early death of bloodstream infection in patients with hematological malignancies from 2012 to 2019 in a Chinese tertiary hospital

2020 ◽  
Author(s):  
Meng Li ◽  
Mingmei Du ◽  
Honghua Li ◽  
Yunxi Liu ◽  
Daihong Liu
Keyword(s):  
Bloodstream Infection ◽  
Hematological Malignancies ◽  
Early Death ◽  
Tertiary Hospital ◽  
Klebsiella Pneumonia ◽  
Gram Negative Bacteria ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Gram Negative ◽  
Resistance Rates

Abstract Background: To investigate epidemiology, antibiotic-susceptibility of pathogens, and risk factors for mortality of bloodstream infection (BSI) in patients with hematological malignancies (HMs).Methods: Single-centre retrospective analysis of BSI episodes in patients with HMs in a Chinese tertiary hospital from 2012 to 2019.Results: Among 17,796 analyzed admissions, 508 BSI episodes (2.85%) were identified. Of the 522 isolates, 326 (62.45%) were Gram-negative bacteria, 173 (33.14%) were Gram-positive bacteria, and 23 (4.41%) were fungi. The incidence of BSI differed significantly among the patients with different HMs (P = 0.000): severe aplastic anemia (6.67%), acute leukemia (6.15%), myelodysplastic syndrome(3.22%), multiple myeloma (1.29%), and lymphoma (1.02%). Escherichia coli (30.65%, 160/522) was the most common pathogens, followed by Coagulase-negative staphylococci (CoNS) (19.35%, 101/522) and Klebsiella pneumonia（9.96%, 52/522). The resistance rates of E. coli, K. pneumonia, P. aeruginosa, and A. baumannii to carbapenems were 6.42%, 15.00%, 27.78%, and 78.95%, respectively. All the Gram-positive pathogens were susceptible to linezolid, and 3 vancomycin-resistant Enterococcus were isolated. The overall 14-day mortality was 9.84%. The mortality of BSI caused by A. baumannii was 73.86%, while caused by other pathogens was 7.36% (p=0.000). A multivariate analysis showed that age >65 years, A. baumannii and non-remission of the malignancy were independent predictors of 14-day mortality.Conclusion: Gram-negative bacteria continued to be the most common pathogens causing BSIs in HM patients. An extensive multi-drug resistant baumanni with high mortality rate in HM patients made empirical antimicrobial choice a highly challenging issue.

scholarly journals Invasive bacteria isolates from children with severe infections in a Nigerian hospital

2009 ◽  
Vol 3 (06) ◽  
pp. 429-436 ◽  
Author(s):  
Anthony O. Onipede ◽  
Adedeji A. Onayade ◽  
Jerome B.E. Elusiyan ◽  
Perpetua O. Obiajunwa ◽  
Ezra O.O. Ogundare ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Vaccine Coverage ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococcus ◽  
Klebsiella Pneumonia ◽  
Bacterial Isolates ◽  
Enterobacter Agglomerans ◽  
Haemophilus Influenza ◽  
Gram Negative ◽  
Severe Infections

Background: Little information is available about the aetiology and epidemiology of serious bacterial infections in Nigeria. This study determined bacterial isolates from blood and cerebrospinal fluid (CSF) of children presenting in the emergency room of a teaching hospital in Nigeria. Method: From October 2005 to December 2006, children aged two to 60 months presenting with signs of acute systemic infections were recruited. Blood culture and CSF specimens were collected and processed using standard microbiological protocols. Data were analysed using SPSS version 11 software. Results: Two hundred and two blood and 69 CSF samples were cultured. Fifty-five (27%) of the blood cultures yielded Gram-negative bacilli and Gram-positive cocci in almost equal proportions. The most common isolates from the blood cultures were Staphylococcus aureus, 26 (12.9%) and atypical coliforms, 13 (6.5%). Others are Klebsiella spp, 3 (1.5%); Klebsiella pneumonia, 2 (1.0%); Escherichia coli, 3 (1.5%); Enterobacter agglomerans, 2 (1.1%); Proteus mirabilis, 2(1%); Pseudomonas spp, 2 (1.0%); Haemophilus influenza, 1 (1.0%); and Coagulase-negative Staphylococcus, 1 (1.0%). Fourteen out of 67 (20.9%) of the CSF samples yielded bacterial isolates: Streptococcus pneumonia, 3 (4.5%); Haemophilus influenza, 8 (11.9%); Hemophilus spp, 1 (1.5%); E. Coli, 1 (1.5%); and atypical coliform, 1 (1.5%). Gram-negative coliform isolates were predominantly resistant to penicillin based antibiotics and co-trimoxazole but sensitive to third-generation cephalosporins and quinolones. A high percentage of S. aureus isolates were multi-drug resistant. Conclusions: Bacterial infections contribute to the significant morbidity among children in our environment. S. aureus was more frequently isolated in sepsis while H. influenzae appears to play a major role in meningitis. Appropriate use of antibiotics is needed to manage affected children effectively. We also recommend improved vaccine coverage of children under the age of five years.

Microbial Cell-Free DNA Identifies Etiology of Bloodstream Infections, Persists Longer Than Conventional Blood Cultures, and its Duration of Detection is Associated with Metastatic Infection in Patients with Staphylococcus aureus and Gram-Negative Bacteremia

2021 ◽  
Author(s):  
Emily M Eichenberger ◽  
Christiaan R de Vries ◽  
Felicia Ruffin ◽  
Batu Sharma-Kuinkel ◽  
Lawrence Park ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Blood Culture ◽  
Bloodstream Infection ◽  
Blood Cultures ◽  
Microbial Cell ◽  
Cell Free Dna ◽  
Gram Negative ◽  
Free Dna ◽  
Metastatic Infection ◽  
Gram Negative Bacteremia

Abstract Background Microbial cell-free DNA (mcfDNA) sequencing of plasma can identify presence of a pathogen in a host. This study evaluated the duration of pathogen detection by mcfDNA sequencing vs. conventional blood culture in patients with bacteremia. Methods Blood samples from patients with culture-confirmed bloodstream infection were collected within 24 hours of the index positive blood culture and 48 to 72 hours thereafter. mcfDNA was extracted from plasma and next-generation sequencing (NGS) applied. Reads were aligned against a curated pathogen database. Statistical significance was defined with Bonferroni adjustment for multiple comparisons (p &lt; 0.0033). Results A total of 175 patients with Staphylococcus aureus bacteremia (SAB; n=66), Gram-negative bacteremia (GNB; n=74), or non-infected controls (n=35) were enrolled. The overall sensitivity of mcfDNA sequencing compared to index blood culture was 89.3% (125/140) and the specificity was 74.3%. Among patients with bacteremia, pathogen specific mcfDNA remained detectable for significantly longer than conventional blood cultures (median 15 days vs. 2 days; p&lt;0.0001). Each additional day of mcfDNA detection significantly increased the odds of metastatic infection (Odds Ratio [OR]: 2.89; 95% Confidence Interval [CI]: 1.53-5.46; p=0.0011). Conclusions Pathogen mcfDNA identified the bacterial etiology of bloodstream infection for a significantly longer interval than conventional cultures, and its duration of detection was associated with increased risk for metastatic infection. mcfDNA could play a role in the diagnosis of partially treated endovascular infections.

scholarly journals Significance of procalcitonin in bacterial infections among acute leukemia patients with post-chemotherapy agranulocytosis

2017 ◽  
Vol 145 (7-8) ◽  
pp. 382-386
Author(s):  
Zhigang Qu ◽  
Bingmu Fang ◽  
Guangli Ma ◽  
Jinhong Jiang ◽  
Xiaoli Wang ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Bacterial Infection ◽  
Bacterial Infections ◽  
Blood Cultures ◽  
Clinical Value ◽  
Infection Group ◽  
Gram Negative ◽  
Positive Group ◽  
The Status ◽  
Diagnosis Of Infection

Introduction/Objective. Bacterial infection caused by the lack of granulocytes that results from the chemotherapy of acute leukemia is the leading cause of death. At present, there are few sensitive markers to reflect the bacterial infection, and there is no obvious specificity for the diagnosis of infection. Procalcitonin (PCT) is a precursor of calcitonin, and it has been found that PCT is a rapid and accurate marker of infectious diseases in various studies, but its clinical value remained unclear. This study aimed to explore the clinical significance of PCT levels in patients with acute leukemia who have acquired bacterial infections during the agranulocytosis period post-chemotherapy. Methods. Serum PCT levels were analyzed from samples collected from 92 patients with acute leukemia who had acquired bacterial infections during the agranulocytosis period post-chemotherapy. Results. Serum PCT levels in patients with positive blood cultures were significantly higher than those in patients with negative blood cultures (? < 0.05). Gram-negative bacterial infection group was significantly more frequent cause of infection than the Gram-positive group (? < 0.05). Furthermore, for patients with positive blood cultures, serum PCT levels were significantly higher in patients who subsequently died than in those who survived (? < 0.05). Conclusion. In the period of agranulocytosis combined with bacterial infection that occurred after the chemotherapy of acute leukemia, PCT can show the status of bacterial infection, infected bacterial types and severities.

scholarly journals Optimizing the Management of Uncomplicated Gram-Negative Bloodstream Infections: Consensus Guidance Using a Modified Delphi Process

2021 ◽  
Vol 8 (10) ◽  
Author(s):  
Emily L Heil ◽  
Jacqueline T Bork ◽  
Lilian M Abbo ◽  
Tamar F Barlam ◽  
Sara E Cosgrove ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Antibiotic Therapy ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Oral Antibiotic ◽  
Gram Negative ◽  
Modified Delphi ◽  
Oral Antibiotic Therapy ◽  
Consensus Statements ◽  
Definition Of

Abstract Background Guidance on the recommended durations of antibiotic therapy, the use of oral antibiotic therapy, and the need for repeat blood cultures remain incomplete for gram-negative bloodstream infections. We convened a panel of infectious diseases specialists to develop a consensus definition of uncomplicated gram-negative bloodstream infections to assist clinicians with management decisions. Methods Panelists, who were all blinded to the identity of other members of the panel, used a modified Delphi technique to develop a list of statements describing preferred management approaches for uncomplicated gram-negative bloodstream infections. Panelists provided level of agreement and feedback on consensus statements generated and refined them from the first round of open-ended questions through 3 subsequent rounds. Results Thirteen infectious diseases specialists (7 physicians and 6 pharmacists) from across the United States participated in the consensus process. A definition of uncomplicated gram-negative bloodstream infection was developed. Considerations cited by panelists in determining if a bloodstream infection was uncomplicated included host immune status, response to therapy, organism identified, source of the bacteremia, and source control measures. For patients meeting this definition, panelists largely agreed that a duration of therapy of ~7 days, transitioning to oral antibiotic therapy, and forgoing repeat blood cultures, was reasonable. Conclusions In the absence of professional guidelines for the management of uncomplicated gram-negative bloodstream infections, the consensus statements developed by a panel of infectious diseases specialists can provide guidance to practitioners for a common clinical scenario.

Assessing Bacterial Isolates in Bloodstream Infections and Trend of the Antimicrobial Resistance in the Hematological and Solid Malignancies

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5628-5628
Author(s):  
Lama Tamang Tsering ◽  
Sindhu Barola ◽  
Abhinav B Chandra
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Hospital Stay ◽  
Hematological Malignancies ◽  
Hematological Malignancy ◽  
Blood Cultures ◽  
Bacterial Isolates ◽  
Gram Negative ◽  
Solid Malignancy ◽  
Solid Malignancies

Abstract Introduction: Infection is a common cause of morbidity and mortality in hemato-oncologic patients receiving chemotherapy. The empiric broad spectrum antibiotic given to patients with fever and features of sepsis has reduced infection related complications and shortened hospital stay. However, the use of empirical antibiotic prophylaxis has caused changes in the spectrum of organisms and emergence of drug resistance. We evaluated the type of bacterial isolates and the resistance patterns in cancer patients. Method: We examined data from cancer patients aged 18 years and older with positive blood cultures from 2012-2014. We estimated the frequency and percentage of blood culture positives bacteria and resistance pattern in hematological and solid malignancy and compared hospital stay and death during admission. Results: 1334 patients were admitted 2012 to 2014 who received at least one course of chemotherapy. We found 167 positive blood cultures among 122 patients from137 admissions. Of these 122 patients, 72.7% had solid malignancy and 27.3% had hematological malignancy. Patients with hematological malignancy had 81.8% gram positive cultures and 19.2% gram negative cultures compared to 78.4% and 21.6%, respectively for patients with solid malignancies. Out of the gram positives, 22.2% were Staphylococcus aureus and 33.3% were coagulase negative staphylococcus in patients with hematological malignancies as opposed to 17.4% and 15.9% respectively in patients with solid malignancies. Among the gram negative positive blood cultures 17.6% grew Escherichia coli and 27.7% grew Klebsiella in patients with hematological malignancies. These numbers were 35.2% and 44.4% in patients with solid malignancies. 59.9% of culture positive bacteria developed resistance to one or more antibiotics in hematological malignancy group where as 56.9% developed it in in solid malignancy group. The percentage of bacterial resistance to 1, 2 and 3 or more antibiotics in hematological and solid malignancies were 18.8 Vs 21.9, 15.9 Vs 13.8 and 22.7 Vs 21.9 respectively. Percentage of extended-spectrum β-lactamases (ESBL), methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) were 6.6%, 3.6 and 4.7% respectively. Having positive blood cultures was associated with increased length of hospital stay - 56.3% of patients with hematological malignancies spent 10 or more days in the hospital as compared to 48.8% of patients with solid malignancy. More deaths were seen in patients with positive blood cultures with hematological malignancies (15.6%) as compared to patients with positive blood cultures with solid malignancies (14.5%). Conclusion: We observed that gram positive bacteremia was more common in our patient population. There seems to be no difference in the incidence and pattern of bacteremia between solid and hematological malignancies. Bacteremia is associated with increased length of stay and mortality. More than one third of bacteria are resistant to 2 or more antibiotics. Therefore, the careful analysis of the types of organisms and pattern of antimicrobial resistance of the isolates at each particular institution is important to develop strategy for empiric antimicrobial therapy for patients with febrile neutropnia and treatment of bacteremia. Disclosures No relevant conflicts of interest to declare.

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