BLOOD-STREAM INFECTIONS DUE TO ANAEROBIC-BACTERIA IN CANCER-PATIENTS - EPIDEMIOLOGY, ETIOLOGY, RISK-FACTORS, CLINICAL PRESENTATION AND OUTCOME OF ANAEROBIC BACTEREMIA

Thirthy one bacteremic episodes (BE) in 31 patients due to anaerobic b acteremia (AB) in 979 BE among 9986 admissions at a 360 beds National Cancer Institute within last 6 years were analyzed for time distributi on, risk factors, clinical presentation and outcome. Overall incidence of AB was 3.6%, but the proportion to other groups of microorganisms is decreasing. 73% were Bacteroides fragilis, 10.8% Peptostreptococci and Propionibacteria and 5.4% Clostridia. The most common risk factor for AB was prior surgery, solid tumor as underlying disease, prophylax is with quinolones and previous therapy with third generation cephalos porines. 48.4% of AB were polymicrobial. Infected wound was the most c ommon source of infection in 38.7% of our cancer patients. Six patient s (19.4%) presented septic shock, and 45.2% died, but only in 22.6% de ath was related to bacteremia. Comparing the groups of AB due to B. fr agilis (BF) to non-Bacteroides spp. (NB)AB, infection-associated morta lity was higher in BFAB in comparison to NBAB. Other risk factors such as hematologic malignancies, previous prophylaxis with quinolones, pr ior surgery and prior therapy with broad spectrum antimicrobials, were more frequently associated with BFAB.