Advertisement

Infection

, Volume 32, Issue 2, pp 65–71 | Cite as

Bloodstream Infections in Patients with Solid Tumors: Associated Factors, Microbial Spectrum and Outcome

  • M. Anatoliotaki
  • V. Valatas
  • E. Mantadakis
  • H. Apostolakou
  • D. Mavroudis
  • V. Georgoulias
  • K. V. Rolston
  • D. P. Kontoyiannis
  • E. Galanakis
  • G. SamonisEmail author
Clinical and Epidemiological Study

Abstract.

Background:

Although patients with malignant diseases are at increased risk for bloodstream infections (BSIs), limited data are available for those with solid tumors.

Patients and Methods:

The etiology, clinical features and outcome of BSIs were retrospectively studied in patients with solid tumors treated at the Department of Medical Oncology at the University Hospital of Heraklion, Greece, from November 1995 through June 2000.

Results:

A total of 157 episodes of BSIs was identified among 137 patients over the study period. The majority of the episodes (128; 82%) occurred in non-neutropenic patients. 80 of 157 (51%) of the episodes were healthcareassociated, 35% (55 of 157) were nosocomial and 14% (22 of 157) were community acquired. A single pathogen was isolated in 86% of the episodes. A total of 184 pathogens was isolated (51% gram-negative rods, 44% gram-positive cocci, 3% anaerobes and 3% fungi), while the portal of entry was identified in 104 of 157 (66%) of the episodes. The site of the primary tumor or the metastases were the source of BSI in 39 of 104 (37.5%) of the episodes with an identified source. The overall infectious mortality was 20% and was significantly higher when the initial empirical antibiotic therapy was inappropriate (39%; p < 0.001) and in the presence of shock (63%; p < 0.001).

Conclusion:

BSIs in patients with solid tumors are frequently healthcare associated and in a large percentage the portal of entry can be identified. Neutropenia is not as common as in patients with hematologic malignancies. Inappropriate initial empirical antibiotic therapy and shock are clinical factors associated with worse outcomes.

Keywords

Primary Tumor Solid Tumor Neutropenia Hematologic Malignancy Large Percentage 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Copyright information

© Urban & Vogel Medien und Medizin Verlagsgesellschaft 2004

Authors and Affiliations

  • M. Anatoliotaki
    • 1
    • 2
  • V. Valatas
    • 1
    • 2
  • E. Mantadakis
    • 1
    • 2
  • H. Apostolakou
    • 1
    • 2
  • D. Mavroudis
    • 1
    • 2
  • V. Georgoulias
    • 1
    • 2
  • K. V. Rolston
    • 3
  • D. P. Kontoyiannis
    • 3
  • E. Galanakis
    • 1
    • 2
  • G. Samonis
    • 1
    • 2
    Email author
  1. 1.University General Hospital of HeraklionCreteGreece
  2. 2.University of Crete, Division of MedicineHeraklion 71003, CreteGreece
  3. 3.Dept. of Medical Specialties, Section of Infectious DiseasesUniversity of Texas M. D. Anderson Cancer CenterHoustonUSA

Personalised recommendations