title: Bloodstream infections in neutropenic patients with cancer: differences between patients with haematological malignancies and solid tumours.
abstract: OBJECTIVE
  We sought to identify the characteristics, aetiology, antibiotic resistance and outcomes of bloodstream infection (BSI) in neutropenic patients with haematological malignancies (HM) and in those with solid tumours (ST) and assess their impact on empirical therapy and outcomes.
  
  
  METHODS
  All episodes of BSI in neutropenic patients with HM and ST were prospectively recorded and compared.
  
  
  RESULTS
  Of 579 episodes of BSI, 493 occurred in patients with HM and 86 in patients with ST. An endogenous source and catheter-related infection were more frequent in patients with HM, whereas pneumonia and urinary tract were more common in the ST group. BSI was mainly due to Gram-negative bacilli. Coagulase-negative staphylococci were more frequent in patients with HM, while Pseudomonas aeruginosa was more common in patients with ST and was the leading cause of pneumonia. Multidrug-resistant Gram-negative bacilli (MDRGNB) were more frequently isolated in haematological patients who more often received inadequate empirical therapy than those with ST. Case-fatality rates were higher in patients with ST.
  
  
  CONCLUSIONS
  We identified significant differences in BSI in neutropenic patients with HM and ST. MDRGNB were more often isolated in patients with HM. Pneumonia due to P. aeruginosa was particularly frequent among patients with ST. Case-fatality rates were higher in patients with ST.
authors: Oncology Department, ICO (Institut Català d'Oncologia) l'Hospitalet, ICO Duran i Reynals, University of Barcelona, Barcelona, Spain. Electronic address: mmarin@iconcologia.net.
authors: Mar
authors: M
authors: Marin
authors: Infectious Disease Service, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, University of Barcelona, Spain; REIPI (Spanish Network for Research in Infectious Disease), Instituto de Salud Carlos III, Madrid, Spain.
authors: Carlota
authors: C
authors: Gudiol
authors: Microbiology Department, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, University of Barcelona, Spain; CIBERes (Centro de Investigación Biomédica en Red en Enfermedades Respiratorias), Instituto de Salud Carlos III, Spain.
authors: Carmen
authors: C
authors: Ardanuy
authors: Infectious Disease Service, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, University of Barcelona, Spain; REIPI (Spanish Network for Research in Infectious Disease), Instituto de Salud Carlos III, Madrid, Spain.
authors: Carol
authors: C
authors: Garcia-Vidal
authors: Oncology Department, ICO (Institut Català d'Oncologia) l'Hospitalet, ICO Duran i Reynals, University of Barcelona, Barcelona, Spain.
authors: Mariona
authors: M
authors: Calvo
authors: Haematology Department, ICO (Institut Català d'Oncologia) l'Hospitalet, ICO Duran i Reynals, Barcelona, Spain; Institut d'InvestigacióBiomèdica de Bellvitge (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors: Montserrat
authors: M
authors: Arnan
authors: Infectious Disease Service, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, University of Barcelona, Spain; REIPI (Spanish Network for Research in Infectious Disease), Instituto de Salud Carlos III, Madrid, Spain.
authors: Jordi
authors: J
authors: Carratalà
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D019337:Hematologic Neoplasms / Q000150:complications* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000382:microbiology; D009503:Neutropenia / Q000150:complications* / Q000382:microbiology; D011014:Pneumonia / Q000188:drug therapy / Q000382:microbiology; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Bacteraemia; Bloodstream infection; Cancer; Neutropenia; Solid tumour