title: Streptococcus agalactiae infection in cancer patients: a five-year study.
abstract: Although the highest burden of Streptococcus agalactiae infections has been reported in industrialized countries, studies on the characterization and epidemiology are still limited in developing countries and implementation of control strategies remains undefined. The aim of this retrospective study was to assess the epidemiological, clinical, and microbiological aspects of S. agalactiae infections in cancer patients treated at a Reference Brazilian National Cancer Institute - INCA, Rio de Janeiro, Brazil. We reviewed the clinical and laboratory records of all cancer patients identified as having invasive S. agalactiae disease during 2010-2014. The isolates were identified by biochemical analysis and tested for antimicrobial susceptibility. A total of 263 strains of S. agalactiae were isolated from cancer patients who had been clinically and microbiologically classified as infected. S. agalactiae infections were mostly detected among adults with solid tumors (94 %) and/or patients who have used indwelling medical devices (77.2 %) or submitted to surgical procedures (71.5 %). Mortality rates (in-hospital mortality during 30 days after the identification of S. agalactiae) related to invasive S. agalactiae infections (n = 28; 31.1 %) for the specific category of neoplasic diseases were: gastrointestinal (46 %), head and neck (25 %), lung (11 %), hematologic (11 %), gynecologic (4 %), and genitourinary (3 %). We also found an increase in S. agalactiae resistance to erythromycin and clindamycin and the emergence of penicillin-less susceptible isolates. A remarkable number of cases of invasive infections due to S. agalactiae strains was identified, mostly in adult patients. Our findings reinforce the need for S. agalactiae control measures in Brazil, including cancer patients.
authors.affiliation: Roberto Alcântara Biology Institute, Rio de Janeiro State University - UERJ, Rio de Janeiro, RJ-LBMFE/IBRAG, Rua São Francisco Xavier, 524 - PHLC 5º andar sala 501B- Maracanã, 20550-013, Rio de Janeiro, RJ, Brazil.
authors.forename: B A S
authors.initials: BA
authors.lastname: Pimentel
authors.affiliation: National Cancer Institute - INCA, Rio de Janeiro, RJ-HICC/HC1, Rio de Janeiro, Brazil.
authors.forename: C A S
authors.initials: CA
authors.lastname: Martins
authors.affiliation: Roberto Alcântara Biology Institute, Rio de Janeiro State University - UERJ, Rio de Janeiro, RJ-LBMFE/IBRAG, Rua São Francisco Xavier, 524 - PHLC 5º andar sala 501B- Maracanã, 20550-013, Rio de Janeiro, RJ, Brazil.
authors.forename: J C
authors.initials: JC
authors.lastname: Mendonça
authors.affiliation: Roberto Alcântara Biology Institute, Rio de Janeiro State University - UERJ, Rio de Janeiro, RJ-LBMFE/IBRAG, Rua São Francisco Xavier, 524 - PHLC 5º andar sala 501B- Maracanã, 20550-013, Rio de Janeiro, RJ, Brazil.
authors.forename: P S D
authors.initials: PS
authors.lastname: Miranda
authors.affiliation: Roberto Alcântara Biology Institute, Rio de Janeiro State University - UERJ, Rio de Janeiro, RJ-LBMFE/IBRAG, Rua São Francisco Xavier, 524 - PHLC 5º andar sala 501B- Maracanã, 20550-013, Rio de Janeiro, RJ, Brazil.
authors.forename: G F
authors.initials: GF
authors.lastname: Sanches
authors.affiliation: Faculty of Medical Sciences, Rio de Janeiro State University - UERJ, Rio de Janeiro, RJ-LDCIC/FCM, Rio de Janeiro, Brazil.
authors.forename: A L
authors.initials: AL
authors.lastname: Mattos-Guaraldi
authors.affiliation: Roberto Alcântara Biology Institute, Rio de Janeiro State University - UERJ, Rio de Janeiro, RJ-LBMFE/IBRAG, Rua São Francisco Xavier, 524 - PHLC 5º andar sala 501B- Maracanã, 20550-013, Rio de Janeiro, RJ, Brazil. pnagao@uerj.br.
authors.forename: P E
authors.initials: PE
authors.lastname: Nagao
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D003131:Combined Modality Therapy; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009026:Mortality; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D011159:Population Surveillance; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D013292:Streptococcus agalactiae / Q000145:classification / Q000187:drug effects / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents