title: Bacterial infections in a hematology and oncology inpatient unit. Changing spectrum of bacteremias.
abstract: The incidence of infection is increased in patients with cancer and certain hematologic disorders. We retrospectively reviewed all the patients evaluated for infection in our Hematology-Oncology unit during a six month period. The purpose of this study was to identify the most common organisms causing infection, evaluate the usefulness of tests performed as well as to determine the outcome and complications of therapy. Contrary to earlier experience the most common organisms causing bacteremia were gram-positive. Despite this finding, gram-negative organisms remained important pathogens specially of the respiratory and urine tract judging by their predominance in urine and sputum cultures. Of the commonly ordered tests, the chest X-ray was the most frequently positive test for infection and the complication rate of antibiotic therapy was 15%. We conclude that in addition to the traditional antibiotics effective against gram-negative organisms, institution of antibiotics effective against gram-positive organisms including Staphylococcus epidermides, should be considered early in the management of these patients.
authors.affiliation: Medical Service, San Juan Veterans Affairs Medical Center, PR 00927.
authors.forename: C O
authors.initials: CO
authors.lastname: Freytes
authors.forename: C
authors.initials: C
authors.lastname: Soldevila
authors.forename: L
authors.initials: L
authors.lastname: Vélez
authors.forename: R
authors.initials: R
authors.lastname: Bermúdez
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006402:Hematologic Diseases / Q000150:complications*; D006760:Hospitalization; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology; D013183:Sputum / Q000382:microbiology; D014556:Urine / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents