title: Polymicrobial septicemia in the cancer patient.
abstract: The medical records of 507 patients with polymicrobial septicemia were examined to determine prognostic and descriptive factors. Over 50% of the episodes occurred in patients with solid tumors and 80% originated during hospitalization. Invasive procedures and immunosuppressive therapy frequently preceded development of polymicrobial septicemia, and infection was often accompanied by shock and pneumonia. A majority of infections were caused by at least 1 aerobic gram-negative bacillus (76%) and anaerobic infections were not infrequent. Overall response among these patients was 50%, with poorest response seen among patients with persistent neutropenia (25%), pneumonia (19%), and gram-negative bacillary infection (46%). Therapy with an antibiotic regimen to which all causative organisms were sensitive was of greatest prognostic significance. Response to appropriate therapy was 58%, whereas only 10% of those who received inappropriate therapy were cured (p less than .0001).
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000382:microbiology; D009504:Neutrophils / Q000276:immunology; D011379:Prognosis; D018805:Sepsis / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D013997:Time Factors; D015003:Yeasts / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents