Prospective evaluation of infection episodes in cancer patients in a tertiary care academic center: Microbiological features and risk factors for mortality Kanser hastalarındaki enfeksiyon ataklarının prospektif değerlendirmesi: Mikrobiyolojik özellikler ve mortalite için risk faktörleri


Başaran N. Ç., Karaağaoğlu E., Hasçelik G., DURUSU TANRIÖVER M., AKOVA M.

Turkish Journal of Hematology, vol.33, no.4, pp.311-319, 2016 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 33 Issue: 4
  • Publication Date: 2016
  • Doi Number: 10.4274/tjh.2015.0216
  • Journal Name: Turkish Journal of Hematology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.311-319
  • Keywords: Cancer, Febrile neutropenia, Mortality, Risk factors
  • Lokman Hekim University Affiliated: No

Abstract

Objective: We aimed to determine the frequency, type, and etiology of infections and the risk factors for infections and mortality in hospitalized cancer patients. Materials and Methods: We prospectively enrolled adult cancer patients hospitalized in the internal medicine wards of a tertiary care academic center between January and August 2004. Patients were followed during their hospitalization periods for neutropenia, infections, culture results, and mortality. Results: We followed 473 cancer patients with 818 hospitalization episodes and 384 infection episodes in total. Seventy-nine percent of the infections were nosocomial, and febrile neutropenia (FN) was observed in 196 (51%) of the infection episodes. Bacteremia was found in 29% of FN episodes and in 8% of nonneutropenic patients. Gram-positive bacteria were the leading cause of bacteremia in both neutropenic and nonneutropenic cases (70% and 58%, respectively). Presence of an indwelling central catheter increased bacteremia risk by 3-fold. The overall mortality rate was 17%, whereas 34% of the patients with bloodstream infections died. Presence of bacteremia and advanced disease stage increased overall mortality by 6.1-fold and 3.7-fold, respectively. Conclusion: Nearly half of the cancer patients developed an infection during their hospital stays, with gram-positive bacteria being the predominant etiologic microorganisms. This demonstrates the changing trends in infections considering that, until 2004, gram-negative bacteria were the most predominant microorganisms among cancer patients in our institute.