Infectious complications of advanced cancer

We present a retrospective study of the frequency, pattern, and management of infections in advanced cancer. Three hundred ninety-three patients were admitted to an acute care palliative medicine unit in an 8-month period for evaluation and palliation of cancer-related symptoms and complications. On e hundred fifteen had at least one positive bacteriological culture, and 10 0 of these patients were evaluable. One hundred fifty-two infections and 19 2 isolates were identified. Sixty-eight patients had polymicrobial infectio ns. Sixty-six patients had urinary tract infections. Forty-one were found t o have multisystemic infections, Eighty-one had invasive devices; 32 had mo re than one invasive device. Fifty-three were taking corticosteroids at the time of infection. Only 3 were neutropenic, Urinary tract infections were significantly more common in those taking corticosteroids. The median durat ion of antibiotic treatment was 11 days and the median hospital stay, 14 da ys. Twenty-eight patients died in the hospital; 10 of those who died had lu ng cancer, which was a statistically significant observation. In conclusion , infections are an underrecognized but common complication in nonneutropen ic hospitalized patients with advanced solid tumors. Urinary tract infectio ns appear to be associated with the use of corticosteroids. Lung cancer pat ients are at greater risk for fatal infections. Infections increase morbidi ty in debilitated patients with solid tumors, are a frequent cause of hospi tal admission, and are associated with significant mortality.