BACTEREMIA IN PATIENTS WITH MALIGNANCIES

Sixty-eight patients with a malignancy who developed bacteremia were e ntered in a retrospective four-year study (1989-1992). Bacteremia was confirmed by microbiological studies in every case. Two-thirds of the patients had acute leukemia and half had severe neutropenia (less than 500 neutrophils/mm(3)). Blood cultures grew Gram-negative bacilli in 72% of cases and Gram-positive cocci in 28%. Enterobacteria were commo n in patients who developed bacteremia within 48 hours of admission. T he rate of occurrence of staphylococcal bacteremia increased with the number of days spent in the hospital. Broad spectrum antimicrobial the rapy with a combination of two drugs was initiated immediately after c ollection of culture specimens. The treatment was adjusted if needed a ccording to antibiotic susceptibility test results. The outcome was fa vorable in 58.3% of cases. Bacteremia due to a Gram-negative bacillus was associated with a higher mortality rate.