BMC Infectious Diseases

June 2008, 8:80,

Emergence of Carbapenem resistant Gram negative and vancomycin resistant Gram positive organisms in bacteremic isolates of febrile neutropenic patients: A descriptive study

Seema Irfan, Faiza Idrees, Vikram Mehraj, Faizah Habib, Salman Adil, Rumina Hasan

Sir this paper will help you

The mucositis is the main cause of BSIs in patients undergoing cancer treatment and in neutropenic. Depending upon the antibiotic scheme they undergo, you can expect a certian susceptibility profile. Enterococci are so-called permissive organisms, they are sometimes recovered from BSIs in polimicrobial samples. Publications are scarce.

Also see:

Management of febrile neutropenia in the era of bacterial resistance Murat Akova and Sehnaz Alp http://tai.sagepub.com/content/1/1/37

The Epidemiology of Bacteremia with Febrile Neutropenia Mical Paul IMAJ 2007;9:424–429

Risk of Infections in Adult Patients with Haematological Malignancies Mette Nørgaard The Open Infectious Diseases Journal, 2012, 6, (Suppl 1: M4) 46-51

I also mean that if Enterobacteriaceae cross the digestive barrier, so should enterococci. Look for them in positive BSIs, but be careful, situations of polimicrobial BSIs are RARE.

Moreover, antibiotic prophylaxis schemes can never cover all microorganisms. The key is to adress the antibiotic policy to the local circulating phenotypes, apply it in patients with MASCC score