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VIRIDANS GROUP STREPTOCOCCI IN LEUKAEMIA AND STEM CELL TRANSPLANT: REVIEW OF A RISK-STRATIFIED GUIDELINE FOR EMPIRIC VANCOMYCIN IN FEBRILE NEUTROPAENIA
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  • Sandra Ruhayel,
  • David Foley,
  • Kate Hamilton,
  • Patricia Ferguson,
  • Rishi Kotecha,
  • Asha Bowen,
  • Daniel Yeoh
Sandra Ruhayel
Perth Children's Hospital Department of Paediatric and Adolescent Oncology and Haematology
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David Foley
Perth Children's Hospital
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Kate Hamilton
Westmead Hospital
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Patricia Ferguson
Westmead Hospital
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Rishi Kotecha
Perth Children's Hospital
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Asha Bowen
THe university of Western Australia, WA Centre for Child Health Research
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Daniel Yeoh
Perth Children's Hospital
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Abstract

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.