VIRIDANS GROUP STREPTOCOCCI IN LEUKAEMIA AND STEM CELL TRANSPLANT:
REVIEW OF A RISK-STRATIFIED GUIDELINE FOR EMPIRIC VANCOMYCIN IN FEBRILE
Viridans group streptococci (VGS) are an important cause of sepsis in
children with cancer. Penicillin-resistance amongst VGS isolates is
increasing. At our institution, vancomycin is added to standard empiric
therapy for febrile neutropaenia in patients at high-risk of VGS sepsis.
We reviewed effectiveness of this risk-stratified approach by examining
episodes of VGS bacteraemia over three years. In 19 VGS bloodstream
infection episodes, 100% of isolates from high-risk patients and 78.9%
of all episodes were susceptible to risk-stratified empiric antibiotics.
Based on blood culture time-to-positivity, empiric vancomycin can be
safely discontinued in stable patients with no growth at 24 hours.