[Infection in neutropenic cancer patients--etiology, microbiological diagnostics, treatment]

Therapy of malignancies is often complicated by neutropenia, which increases the risk of severe and rapidly progressing infections caused by bacteria and fungi. The etiology of infections in the past few decades has shifted from gram-negative to gram-positive organisms. Nowadays the most important pathogens are: coagulase-negative staphylococci, alpha-haemolyic streptococci, Staphylococcus aureus and among gram-negative bacteria: Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa. Because the progress of infection in this group of patients can be rapid, empirical antibiotic therapy should be administrated at the onset of fever. Before starting therapy specimen for microbiological culture should be taken. There are many approaches to antibiotic empirical therapy but the most frequently used is the combination of broad-spectrum beta-lactams (cefiazidime, ceftpime, piperacillin/tazobactam, carbapenem) plus aminoglycoside or monotherapy using an extended spectrum beta-lactam.