Abstract
Introduction: Bacteremia is a cause of morbi-mortality in cancer patients, due to its severity, longer hospital stays, chemotherapy withdraw, and increased costs. The study aimed to clarify if bacteriemia in cancer patients is associated with higher mortality rates and alert the community to this emerging problem.
Methods: The authors collected every cancer patient hospitalized in our cancer center, who developed bacteremia during their stay in hospital or at admission, in the last 9 years. Data was treated with SPSS. The p-values <0.05 were considered to be statistically significant.
Results: From 204 bloodstream infections, almost half of the patients had gastrointestinal cancer (49%). Males were predominant (54,4%) and the median age was 66 years-old. The catheter-totally-implanted was responsible in 38,7% of the cases. From all bacteria, 20,5% were multidrug-resistant and 48% were resistant to at least one antibiotic. From all patients, 61,5% received chemotherapy the month before the infection. The survival of those that did received chemotherapy was significantly different from patients that did not, t(203)= 2,06, p=0,04. Chemotherapy the month before was correlated with lower survival rates, r(203)=-0,15, p=0,03, and Kaplan-Meyer curve showed a tendency towards statistically significance (p=0,06). The stage of the oncologic disease was not associated with the mortality of the patient (p>0,05). The infection contributed or was the cause of death in 45% of the patients. The 3 months mortality rate of the patients that had bacteriemia was 74,5%.
Conclusion: Currently there are no guidelines regarding prescription of antimicrobial therapy in cancer patients. Three quarters of the cancer patients that suffer bacteriemia died in 3 months, and active chemotherapy treatment is associated with lower survival rates.
Keywords: oncology; bloodstream infection; multidrug-resistant bacteria; antibiotic stewardship.