Changing trends in etiology of bacteremia in patients with cancer

• Published in: European journal of clinical microbiology & infectious diseases Vol. 25; no. 8; pp. 522 - 526
• Main Authors: SAFDAR, A, RODRIGUEZ, G. H, BALAKRISHNAN, M, TARRAND, J. J, ROLSTON, K. V. I
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.08.2006; Springer Nature B.V
• Subjects: Bacteremia - etiology; Bacteria; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Cancer; Drug Resistance, Bacterial; Gram-positive bacteria; Human bacterial diseases; Humans; Infectious diseases; Medical sciences; Neoplasms - complications; Retrospective Studies; Staphylococcus infections; Infection; Human; Microbiology; Etiology; Bacteriosis; Malignant tumor; Bacteremia; Cancer
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-006-0173-4

The present study was conducted to determine trends in the quantitative bacterial load patterns of bacterial bloodstream infections (BSI) caused by various bacteria in patients receiving care at a comprehensive cancer center. Bacterial loads of all consecutive quantitative blood cultures performed during 1998 and 2004 were graded quantitatively. Gram-positive bacteria (GPB) were responsible for the majority of BSI episodes in both years studied: 740 of 1,055 (73%) in 1998 and 820 of 1,025 (82%) in 2004. Compared with GPB infections, a significant proportion of infections caused by Gram-negative bacteria was associated with a high bacterial load (HBL) (11 vs 28% in 1998 and 10 vs 30% in 2004; p<0.001). In 2004, BSI episodes due to non-Pseudomonas non-fermentative GNB (Stenotrophomonas maltophilia and Acinetobacter spp) were significantly associated with a HBL compared to BSI due to Pseudomonas aeruginosa (47 vs 23%; p<0.05); this was not the case in 1998. Conversely, the HBLs commonly associated with BSI due to Staphylococcus aureus (50%) and Streptococcus spp (35%) versus coagulase-negative staphylococci (13%; p<0.0001) during 1998 were not noted during 2004 (22% Staphylococcus aureus, 20% Streptococcus spp, 21% coagulase-negative staphylococci; p>0.5). The spectrum of BSI continues to change and its prognostic implications in cancer patients needs further study.