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Polymicrobial infection in patients with cancer: an underappreciated and underreported entity
Kenneth V I Rolston1, Gerald P Bodey, Amar Safdar
1The University of Texas, M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Abstract:
Polymicrobial infections account for ~15% of infections in immunocompromised patients with cancer. However, limited information exists regarding the spectrum and microbiology of these infections, even in severely neutropenic patients. Most studies describe only monomicrobial bloodstream infections in detail, and information regarding polymicrobial infections and nonbacteremic infections is often incomplete or not provided at all. The current lack of well-established definitions for various infections in the immunocompromised host, including pneumonia, neutropenic enterocolitis, and polymicrobial infections, probably plays an important role in the paucity of published information. In this review, we briefly describe the limited information available regarding polymicrobial infections in patients with cancer and address the need for establishing consensus definitions for site-specific polymicrobial infections in neutropenic and nonneutropenic patients. We anticipate that, as factual information regarding such infections becomes available, a more comprehensive understanding of the true scope and impact of these infections will emerge, leading to appropriate modifications in the diagnostic work-up and in the therapeutic approaches used in treating these patients.
Insights
Polymicrobial infections are common in cancer patients but poorly understood. Establishing clear definitions is crucial for better diagnosis and treatment of these complex infections.
Area of Science:
- Infectious Diseases
- Oncology
- Microbiology
Background:
- Polymicrobial infections represent approximately 15% of infections in cancer patients.
- Existing research often focuses on monomicrobial infections, leaving polymicrobial and non-bacteremic infections under-documented.
- Lack of standardized definitions for infections in immunocompromised hosts hinders comprehensive understanding.
Purpose of the Study:
- To review the limited available data on polymicrobial infections in cancer patients.
- To highlight the critical need for consensus definitions for site-specific polymicrobial infections.
- To advocate for improved diagnostic and therapeutic strategies.
Main Methods:
- Literature review of existing studies on polymicrobial infections in cancer patients.
- Analysis of current gaps in knowledge and definitions.
- Discussion of implications for clinical practice.
Main Results:
- Significant lack of detailed information on the spectrum and microbiology of polymicrobial infections.
- Inconsistent or absent data on non-bacteremic polymicrobial infections.
- Absence of established definitions for key infections like pneumonia and neutropenic enterocolitis.
Conclusions:
- There is a pressing need for standardized definitions for polymicrobial infections in both neutropenic and non-neutropenic cancer patients.
- Developing consensus definitions will facilitate a better understanding of infection scope and impact.
- This understanding is essential for refining diagnostic work-ups and therapeutic interventions.
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