title: A prospective study of characteristics and outcomes of bacteremia in patients with solid organ or hematologic malignancies.
abstract: OBJECTIVE
  To study the epidemiology and outcomes of bacteremia in patients with hematologic or solid organ malignancies cared for at the University Hospital of Heraklion, Greece.
  
  
  METHODS
  This prospective study was conducted during a 4-year period (2007-2011). Patients with bacterial and fungal blood stream infections were followed until discharge. Mortality was the primary outcome, while duration of hospitalization, relapses, time to relapse, and defervescence were the secondary outcomes.
  
  
  RESULTS
  Ninety-nine patients with neoplasia (104 episodes) were included. Bacteremia developed mainly in patients with hematologic malignancies (56%). Secondary bacteremias due to respiratory and urinary tract infections were most commonly identified. Gram-negative bacteria were the predominantly isolated pathogens (65%); Pseudomonas spp. was the most common cause (19%), followed closely by E. coli (18%) and Klebsiella pneumoniae (17%). In-hospital mortality was 26.2%. No differences in mortality were seen among patients in different subgroups according to isolated bacteria (according to Gram's stain, species, or number of isolated bacteria in positive cultures), hematologic or solid organ malignancy, neutropenia, and primary or secondary bacteremia. However, patients with bacteremia due to extensively drug resistant bacteria had higher mortality than patients with bacteremia due to multidrug resistant or susceptible pathogens. Patients required a prolonged period of hospitalization (21.8 ± 14.9 days), which was complicated with relapses or reinfections in another body site in 27 % of them.
  
  
  CONCLUSIONS
  Gram-negative bacteria were the predominantly isolated pathogens from patients with cancer in our population. The overall mortality remains high.
authors.affiliation: Department of Internal Medicine, University of Crete, Heraklion, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Samonis
authors.forename: Konstantinos Z
authors.initials: KZ
authors.lastname: Vardakas
authors.forename: Sofia
authors.initials: S
authors.lastname: Maraki
authors.forename: Giannoula S
authors.initials: GS
authors.lastname: Tansarli
authors.forename: Dimitra
authors.initials: D
authors.lastname: Dimopoulou
authors.forename: Diamantis P
authors.initials: DP
authors.lastname: Kofteridis
authors.forename: Angeliki M
authors.initials: AM
authors.lastname: Andrianaki
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Falagas
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000382:microbiology / Q000401:mortality*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology / Q000401:mortality*; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology / Q000401:mortality*; D006115:Greece / Q000453:epidemiology; D019337:Hematologic Neoplasms / Q000382:microbiology / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000382:microbiology / Q000401:mortality; D009369:Neoplasms / Q000382:microbiology / Q000401:mortality*; D009503:Neutropenia / Q000382:microbiology / Q000401:mortality; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000382:microbiology / Q000401:mortality; D014552:Urinary Tract Infections / Q000382:microbiology / Q000401:mortality