1559P - Epidemiology, resistance profile and origin of bacteremia in non-neutropenic patients with solid tumor

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Supportive Care
Presenter Mansouriah Merad
Authors M. Merad, E. Chachaty, B. Gachot, A.T. Alibay, M. Dipalma, A. Sami
  • Ambulatory Care, Gustave Roussy Institute, 94805 - Villejuif/FR

Abstract

Background

Few microbiological data are available in febrile patients with solid tumors without neutropenia. Recently we have observed an increase in bacteria resistance in immuno compromised patients and particularly with hematological diseases.

The aim of this study is to describe the bacteremia occurring in solid tumors, and to identify a potential association with other sites of infection.

Methods

This retrospective study was conducted in an emergency oncology department (EOD) in a cancer hospital (2010-2011). In our EOD, 5200 patients with cancer are admitted for an unexpected event/year; 15% of them are admitted for exploration of fever. The records of bacteriemia and positive microbiological sample from other sites were analyzed. The samples were taken at the same time. Urinary, skin and/or sputum samples were analyzed according to clinical symptoms. Central venous catheter infection (CVC) was defined with the differential time to positivity between hub-blood and peripheral–blood cultures.

Results

We reported 290 episodes of bacteremia. Gram-positive represented 58% of the organisms isolated from blood culture: coagulase-negative staphylococci (CNS) (n = 105), Staphylococcus aureus (SA) (n = 38) (only one was methicillin-resistant), S. pneumoniae (n= 7), Streptococcus sp (n = 29). The majority of gram-negative were Enterobacteria (E) (n = 97) and most of them were E coli (n = 62). Only 2 (E coli) developed extended spectrum beta-lactamases resistance. Pseudomonas sp, other gram-negative, anaerobes and Candida sp counted, respectively, 12, 12, 11 and 6 bacteremia. One microorganism was identified in 270 bacteremia cases. Two ore more microorganisms were found in 35 and 6 bacteremia cases, respectively. All the bacteremia were related to CVC when CNS, SA and Candida sp were identified excepted 3/38 of SA linked to a skin infection. For the E, 25/98 were attributed to a catheter infection and 45 to a urinary tract infection. It is important to highlight that all the bacteremia cases were associated with another site of infection.

Conclusion

In patients with solid tumors without neutropenia, all bacteremia are associated with documented sites of infection. It is important to point out that the bacteria resistance in our department is the exception (1%) and 58% of the bacteremia were gram-positive microorganisms.

Disclosure

All authors have declared no conflicts of interest.