Pneumococcal bacteremia in cancer patients

Area of Science:

• Infectious Diseases
• Oncology
• Internal Medicine

Background:

• Streptococcus pneumoniae bacteremia is a serious complication in cancer patients.
• Cancer patients, particularly those with hematological malignancies or solid tumors, are at increased risk.
• Neutropenia and septic shock are common comorbidities in this population.

Purpose of the Study:

• To review episodes of Streptococcus pneumoniae bacteremia in cancer patients.
• To analyze patient characteristics, clinical sources, empirical treatments, and outcomes.
• To compare current findings with previous studies from the same institution.

Main Methods:

• Retrospective review of 28 episodes of Streptococcus pneumoniae bacteremia in 27 cancer patients.
• Data collected on patient demographics, malignancy type, neutropenia status, septic shock, clinical source, empirical antibiotic treatment, and mortality.
• Comparison with a prior similar study.

Main Results:

• Forty-four percent of patients were neutropenic; 36% were in septic shock.
• No clinical source was identified in 36% of cases.
• Patients receiving empirical beta-lactam treatment had better outcomes than those not treated; 2 patients died within 12 hours without empirical treatment.
• Overall mortality was high, with 11/27 patients dying within the first week and 8/27 within the first three days.
• Mortality did not differ between neutropenic and non-neutropenic patients.
• No significant differences in incidence, patient type, source, or mortality were observed compared to a previous study.

Conclusions:

• Streptococcus pneumoniae bacteremia poses a significant threat to cancer patients, with high early mortality.
• Empirical antibiotic therapy appears crucial for improving survival in these vulnerable patients.
• The study did not reveal changes in the epidemiology or outcomes of S. pneumoniae bacteremia in cancer patients over time at this institution.