Virulence

ISSN: 2150-5594 (Print) 2150-5608 (Online) Journal homepage: http://www.tandfonline.com/loi/kvir20

Bloodstream infection in patients with solid tumors Carlota Gudiol, José María Aguado & Jordi Carratalà To cite this article: Carlota Gudiol, José María Aguado & Jordi Carratalà (2016): Bloodstream infection in patients with solid tumors, Virulence, DOI: 10.1080/21505594.2016.1141161 To link to this article: http://dx.doi.org/10.1080/21505594.2016.1141161

Accepted author version posted online: 19 Jan 2016.

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Date: 26 January 2016, At: 23:13

Bloodstream infection in patients with solid tumors Carlota Gudiol1,3,4,*, José María Aguado2,3, Jordi Carratalà1,3. 1

Department of Infectious Diseases, Hospital Universitari de Bellvitge; Institut

d’Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain 2

Unit of Infectious Diseases Hospital 12 de Octubre, Instituto de Investigación Hospital

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12 de Octubre (i+12), Complutense University, Madrid, Spain 3

REIPI (Spanish Network for Research in Infectious Disease), Instituto de Salud Carlos

III. 4

Institut Català d’Oncologia.

*

Corresponding author: Dr Carlota Gudiol, MD, PhD. Department of Infectious

Diseases, Hospital Universitari de Bellvitge, Feixa Llarga s/n, 08907 l´Hospitalet de Llobregat, Barcelona, Spain. Institut Català d’Oncologia. ABSTRACT Little information is currently available regarding bloodstream infection (BSI) in patients with solid tumors who, for a variety of reasons, are particularly predisposed to develop this condition. In this review we focus on the incidence, epidemiology, clinical features, etiology, antimicrobial resistance, and outcomes of BSI of adult cancer patients with solid tumors. Most episodes of BSI occur in non-neutropenic patients, in whom the site of primary or metastatic tumor often serves as the portal of entry. The urinary tract and the abdomen are the most frequent sources of infection, and 1

cholangitis is the most common recurrent source of BSI. Gram-negative bacilli are becoming the leading cause of BSI in patients with solid tumors, and the rate of multidrug resistance is increasingly being recognized. The case-fatality rate in patients with solid tumors and BSI is high, especially among those with comorbidities, advanced neoplasms, corticosteroid therapy, and shock at presentation. Key words

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bloodstream infection, bacteremia, solid tumor, solid malignancy, solid neoplasm, cancer.

2

1- INTRODUCTION Bloodstream infection (BSI) represents a major complication in cancer patients. In fact, cancer is the most common comorbid condition in patients with sepsis, reported to be present in approximately 17% of cases.1 BSI in cancer patients may delay initiation of chemotherapy and reduce the dosage that can be administered; also, it prolongs

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hospitalization, increases costs and raises morbidity and mortality.2 In a study performed in a large community hospital in The Netherlands, Bos et al. found that 90day mortality in patients with BSI and cancer (mainly solid tumors) was significantly higher than in patients without cancer.3 Most of the information available on BSI in patients with cancer involves patients with hematologic malignancies and HSCT recipients, who are considered the group of cancer patients with the highest risk for bacterial infections due to the frequently prolonged (>7 days) and profound (

Bloodstream infections in patients with solid tumors.

Little information is currently available regarding bloodstream infection (BSI) in patients with solid tumors who, for a variety of reasons, are parti...
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