1836P Bacteraemia in cancer patients: An adverse prognostic factor and the relationship with chemotherapy

Abstract

Bloodstream infection is a cause of morbi-mortality in cancer patients. The study aimed to clarify if bacteraemia in cancer patients is associated with higher mortality rates and to alert the community to this emerging problem. The authors collected every cancer patient hospitalized in our cancer centre, who developed bacteraemia during their stay in hospital or at admission in the last 9 years. Data was treated with SPSS (t-student test, pearson correlation coefficient, bivariate analysis and Kaplan-Meier Curve). P values <0.05 were considered to be statistically significant. A total of 204 bloodstream infections were reported, with positive cultural isolations. Almost half of the patients had gastrointestinal cancer (49%), followed by breast cancer (15,5%). Males were predominant (54,4%) and the median age was 66 years old. Catheter totally implanted (CTI) was responsible in 38,7% of the cases, and 28,9% had no identified focus. The responsible microorganism was E. coli in 24,5%, followed by S. aureus in 14,7% of the infections. From all bacteria, 20,5% were multidrug-resistant bacteria and 48% were resistant to at least one antibiotic. S. aureus was meticilin-resistent in 37% of infections and 4% were carbapenemase producing organisms. From all patients included in the study, 61,5% received chemotherapy the month before the infection. The survival of the patients that 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 to statistical 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-month mortality rate of the patients that had bacteraemia was 74,5%. There are no guidelines regarding prescription of antimicrobial therapy in cancer patients or in palliative care. Three quarters of the cancer patients that suffer from bacteraemia died within 3 months, and active chemotherapy treatment was associated with lower survival rates. CTI was the main source of infection.