Bloodstream infections in patients with solid tumors

Virulence. 2016 Apr 2;7(3):298-308. doi: 10.1080/21505594.2016.1141161. Epub 2016 Jan 19.

Abstract

Little information is currently available regarding bloodstream infection (BSI) in patients with solid tumors who, for a variety of reasons, are particularly predisposed to develop this condition. In this review we focus on the incidence, epidemiology, clinical features, etiology, antimicrobial resistance, and outcomes of BSI of adult cancer patients with solid tumors. Most episodes of BSI occur in non-neutropenic patients, in whom the site of primary or metastatic tumor often serves as the portal of entry. The urinary tract and the abdomen are the most frequent sources of infection, and cholangitis is the most common recurrent source of BSI. Gram-negative bacilli are becoming the leading cause of BSI in patients with solid tumors, and the rate of multidrug resistance is increasingly being recognized. The case-fatality rate in patients with solid tumors and BSI is high, especially among those with comorbidities, advanced neoplasms, corticosteroid therapy, and shock at presentation.

Keywords: bacteremia; bloodstream infection; cancer; solid malignancy; solid neoplasm; solid tumor.

Publication types

  • Review

MeSH terms

  • Abdomen / microbiology
  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / complications*
  • Bacteremia / drug therapy
  • Bacteremia / epidemiology
  • Bacteremia / mortality
  • Cholangitis / microbiology
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Gram-Negative Bacteria / drug effects
  • Humans
  • Incidence
  • Male
  • Neoplasms / complications*
  • Neoplasms / microbiology*
  • Risk Factors
  • Shock, Septic / microbiology
  • Shock, Septic / mortality
  • Urinary Tract / microbiology

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents