1070. Bloodstream Infections in Adult Patients with Cancer: Clinical Features and Pathogenic Significance of Staphylococcus aureus Bacteremia
Session: Poster Abstract Session: Infection in Immunocompromised Patients
Saturday, October 22, 2011
Room: Poster Hall B1
Background: Although prevention and management of bacteremia have improved progressively in recent years, these infections are still among the most common infectious complications observed in cancer patients. The aim of this study was to more precisely delineate the characteristics and outcomes of bloodstream infections in adult cancer patients.

Methods: Using a database for nationwide surveillance of bacteremia, we analyzed data related to bacteremia in adult patients with cancer in order to evaluate clinical features and outcomes and to define predictive factors for mortality.

Results: Of 1246 patients, 919 (73.8%) had solid tumors and 350 (28.1%) had hematologic malignancies. The following conditions were more common in the neutropenic group than in the non-neutropenic group: nosocomial acquisition, hematologic malignancy, corticosteroid use, immunosuppressant use, primary bacteremia, and pneumonia (all P < 0.05). The infections were caused by Gram-negative bacilli in 55.6% (693/1246) and by Gram-positive cocci in 32.7% (408/1246). Gram-negative pathogens were more frequently isolated from neutropenic patients than from non-neutropenic patients (61.9% vs. 53.5%, P=0.010), with a significant predominance of Escherichia coli and Klebsiella pneumoniae. The overall 30-day mortality rate was 24.1% (241/1001), and multivariate analysis showed that Staphylococcus aureus bacteremia was a significant factor associated with mortality (OR, 1.79; 95% CI, 1.01-3.16; P=0.046), along with nosocomial acquisition, pneumonia, severe sepsis or septic shock, and higher Pitt bacteremia score (all P-values < 0.05). When risk factors for S. aureus bacteremia in adult cancer patients were evaluated, skin and soft tissue infection, nasogastric tube, pneumonia, and corticosteroid use were found to be significantly associated with S. aureus bacteremia (all P-values < 0.05).

Conclusion: This study represents the largest comprehensive assessment of bloodstream infections in neutropenic versus non-neutropenic adult cancer patients. Given the pathogenic significance of S. aureus bacteremia in adult patients with cancer, additional strategies for the management of S. aureus bacteremia in cancer patients are needed in order to improve outcomes.


Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

Cheol-In Kang, MD, Jae-Hoon Song, MD, Doo Ryeon Chung, MD and Kyong Ran Peck, MD, Division of Infectious Diseases, Samsung Medical Center, Seoul, South Korea

Disclosures:

C. I. Kang, None

J. H. Song, None

D. R. Chung, None

K. R. Peck, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.