ANALYSIS OF 553 EPISODES OF MONOMICROBIAL BACTEREMIA IN CANCER-PATIENTS - ANY ASSOCIATION BETWEEN RISK-FACTORS ACID OUTCOME TO PARTICULAR PATHOGEN

Relationships between aetiology, various risk factors (such as neutrop enia, catheter insertion, endoscopy, therapy with corticosteroids, the rapeutic use of antimicrobials, antibiotic prophylaxis, source of infe ction), symptomatology and outcome were studied in 553 monomicrobial b acteraemic episodes in cancer patients observed within 7 years at the National Cancer Institute of the Slovak Republic, The ratio of gram-po sitive to gram-negative bacteraemia was 1:1 (43.5% vs 43.8%), and yeas ts: caused 7.2% of monomicrobial episodes. The highest mortality was a ssociated with Pseudomonas aeruginosa (19.2%), non-albicans Candida ye asts (25%) and Bacteroides fragilis (22.6%). Independent risk factors for particular pathogens were investigated by a computerized logistic regression model. The only independent risk factor for staphylococcal and enterococcal bacteraemia was vascular catheter insertion (OR = 1.9 5 and 2.05, CI = 95%, P=0.035 and 0.044, respectively). However, there were no independent specific risk significant factors for viridans st reptococcal bacteraemia and bacteraemia due to Enterobacteriaceae or P s, aeruginosa, Neutropenia was found to be an independent predictor fo r development of Acinetobucter spp. bacter aemia (OR = 3.84, CI = 95%, P=0.044). Prior therapy with third-generation cephalosporines was a p redictive, independent risk factor for the development of fungaemia (O R = 1.99, CI= 95%, P=0.028) but not of enterococcal bacteraemia. We al so did not observe ally association between prior therapy with imipene m and Stenotrophomonas maltophilia bacteraemias. Multivariate analysis confirmed that fungaemia may be independently associated with higher mortality than bacteraemia caused by Enterobacteriaceae and staphyloco cci. However, the mortality of fungaemia was statistically no differen t from that of Ps. aeruginosa. Stenotrophomonas spp and viridans strep tococci bacteraemias.