Molecular Epidemiology and Risk Factors of Staphylococcus epidermidis Isolated from Patients with Acute Leukemia / 병원감염관리

ABSTRACT

BACKGROUND: The purpose of this study is to define the risk factors of S. epidermidis acquisition and the epidemiology of strain variation in acute leukemia patients. METHODS: The participants were 155 patients of acute leukemia admitted in a University hospital for 11 months. 83 patients are the isolated group who had isolated S. epidermidis from body sites (blood, oral cavity, nares, rectum) and 72 patients are the not isolated group who had not isolated S. epidermidis. Isolates were analysed by CHEF and cluster analysis with dendrogram. Differences In proportions were tested with the Chi-square and Fisher's exact test. RESULTS: Ninety-one S. epidermidis were obtained from blood, oral cavity, nares, and rectum. The major proportion of positive culture was 81.3% from nares. Eight-nine S. epidermidis were isolated from healthcare workers. There were significant development of bacteremia in patients with S. epidermidis from nares. Resistance rate of S. epidermidis was 75.8% to methicillin, 86.3% to erythromycin, 81.l% to gentamicin, 68.9% to ciprofloxacin, 0% on vancomycin. There was significant difference on resistance rate between patients and healthcare workers' group. There was no relation between the strain of patients and those of healthcare workers. Sex age, diagnosis, length of stay, type of chemotherapy, duration of chemotherapy, Type of central venous catheter. duration of central venous catheter, prior antibiotic therapy, number of antibiotics, site of nosocomial infection, neutropenic period were not significantly different between S. epidermidis isolated group and not isolated group. Significant risk factors included duration of central venous catheter. hyper-alimentation, and folliculitis. CONCLUSION: Our result suggests that S. epidermidis in nares can be a risk factor of bacteremia. This research would be helpful for decreasing the S. epidermidis of immunocompromised patients.