Epidemiology of bloodstream infections at a Cancer Center
São Paulo med. j
;
118(5): 131-8, Sept. 2000.
Article
Dans Anglais
| LILACS
| ID: lil-271286
ABSTRACT
CONTEXT Cancer patients are at unusually high risk for developing bloodstream infections (BSI), which are a major cause of in-hospital morbidity and mortality. OBJECTIVE:
To describe the epidemiological characteristics and the etiology of BSI in cancer patients.DESIGN:
Descriptive study.SETTING:
Terciary Oncology Care Center.PARTICIPANTS:
During a 24-month period all hospitalized patients with clinically significant BSI were evaluated in relation to several clinical and demographic factors.RESULTS:
The study enrolled 435 episodes of BSI (349 patients). The majority of the episodes occurred among non-neutropenic patients (58.6 percent) and in those younger than 40 years (58.2 percent). There was a higher occurrence of unimicrobial infections (74.9 percent), nosocomial episodes (68.3 percent) and of those of undetermined origin (52.8 percent). Central venous catheters (CVC) were present in 63.2 percent of the episodes. Overall, the commonest isolates from blood in patients with hematology diseases and solid tumors were staphylococci (32 percent and 34.7 percent, respectively). There were 70 episodes of fungemia with a predominance of Candida albicans organisms (50.6 percent). Fungi were identified in 52.5 percent of persistent BSI and in 91.4 percent of patients with CVC. Gram-negative bacilli prompted the CVC removal in 45.5 percent of the episodes. Oxacillin resistance was detected in 26.3 percent of Staphylococcus aureus isolates and in 61.8 percent of coagulase-negative Staphylococcus. Vancomycin-resistant enterococci were not observed. Initial empirical antimicrobial therapy was considered appropriate in 60.5 percent of the cases.CONCLUSION:
The identification of the microbiology profile of BSI and the recognition of possible risk factors in high-risk cancer patients may help in planning and conducting more effective infection control and preventive measures, and may also allow further analytical studies for reducing severe infectious complications in such groups of patients
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Établissements de cancérologie
/
Bactériémie
/
Mycoses
/
Tumeurs
Type d'étude:
Etude d'étiologie
/
Étude pronostique
/
Facteurs de risque
/
Étude de dépistage
Limites du sujet:
Adolescent
/
Adulte
/
Aged80
/
Enfant
/
Enfant d'âge préscolaire
/
Femelle
/
Humains
/
Bébé
/
Mâle
/
Nouveau-né
langue:
Anglais
Texte intégral:
São Paulo med. j
Thème du journal:
Cirurgia Geral
/
Cincia
/
Ginecologia
/
Médicament
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Année:
2000
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Federal University of Rio de Janeiro/BR
/
Instituto Nacional do Câncer/BR
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