Objective: Infections are major causes of morbidity and mortality in patients with cancer. We aimed to determine the epidemiological features and etiologic agents in healthcare-associated infections (HCAI) in adult patients with solid tumors.
Material and Methods: Patients with solid tumors admitted to oncology unit of Antalya Education and Research Hospital between January 2012- December 2014 were evaluated retrospectively.
Results: There were 65 HCAI in 48 patients (35 with one, nine with two, and four with three episodes). In 92.3% of the episodes, the patients were neutropenic. There were 18 (27.7%) bloodstream infection (BSI), one (1.5%) central line-associated BSI, 14 (21.5%) pneumoniae, 11 (17.0%) urinary tract infection (UTI), seven (10.7%) secondary bacteremia, eight (12.3%) catheter-associated UTI and six (9.3%) soft tissue infections. Totally, 70 agents including 77.1% gram-negative, 17.1% gram-positive and 5.8% fungi were isolated. The most frequent microorganism was Escherichia coli (41.4%), 65.5% were producing extended spectrum beta-lactamase (ESBL). Acinetobacter baumannii isolates were resistant to carbepenems, coagulase negative staphylococci (CNS) isolates were resistant to methicillin. BSI rate was 40.0% and 28 microorganisms including 64.2% gram-negative, 32.1% gram-positive and 3.7% fungi were isolated. The most frequent microorganisms were E.coli (39.2%) and CNS (25.0%).
Conclusion: For effective empirical antimicrobial therapy, knowing the local causative agents and resistance patterns is important in immunosuppressive patients. In the light of these findings, in centers with high rate of infections caused by ESBL producing bacteria or in case of suspicion of infection with methicilin resistant gram-positive bacteria, initial antimicrobial therapy can be extended covering these agents.
Key words: Healthcare-Associated İnfections; Oncology; Solid Tumors.
|
