FUNGAL PATHOGENS IN ETIOLOGY OF SEPTIC SHOCK IN NEUTROPENIC PATIENTS WITH CANCER

During the 3 years from 1989 to 1991, we evaluated the etiology of sep tic shock cases and infection-associated mortality. A total number of 38 patients was included in the study, according to the criteria for s eptic shock (SS), (Intensive Care Medicine Society, 1989). In 1989, P. aeruginosa and Enterobacteriaceae among the pathogens prevailed. In 1 990 and 1991, S. aureus, enterococci and fungi were most frequent. Fro m 8 patients with SS in 1990, the shock was due to Candida albicans in 1 and to mucoraceae in 3 patients. In 10 patients examined in 1991, 8 cases of SS were due to Candida albicans, Aspergillus niger, Fusarium solani and Acremonium strictum. The decrease of the incidence of shoc ks and increase of fungal etiology were found to be associated with th e use of quinolones in prophylaxis and cephalosporines, aminoglycoside s and vancomycine in empiric therapy in febrile neutropenic patients.