PREDOMINANCE OF GRAM-POSITIVE MICROORGANISMS AS A CAUSE OF SEPTICEMIAIN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES

OBJECTIVE: To ascertain the etiology and outcome of episodes of bacter emia and fungemia over a three-year period (1990-1992) in patients wit h hematological malignancies. DESIGN: Retrospective study. SETTING: He matology service of a 1,500-bed Spanish university hospital. RESULTS: Of a total of 178 episodes of significant bacteremia or fungemia in 10 1 patients, 53% affected patients with acute leukemia. Gram-positive m icroorganisms were found to be the cause in 70% of the monomicrobial e pisodes. The most frequently isolated microorganism was coagulase-nega tive Staphylococcus (35%), followed by Staphylococcus aureus (11%). Mo st bloodstream infections occurred during an episode of neutropenia (5 9%). A total of 34 patients died during hospitalization; in 14, infect ion was the cause of death. CONCLUSIONS: A marked increase in the inci dence of bacteremias caused by gram-positive microorganisms has been o bserved in our hospital over the last 10 years, especially in patients with hematological malignancies. The mortality due to bacteremia is s imilar to that found by other authors in series of bacteremia in hemat ological patients, and we have not found significant differences in di e mortality due to bacteremia between neutropenic and nonneutropenic p atients (Infect Control Hosp Epidemiol 1994;15:101-104).