Archives of Clinical Microbiology

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Hospital-Acquired Bloodstream Infections in Cancer Patients between 2005 and 2007 in a Turkish University Hospital.

B Kurtaran, A Candevir, Y Tasova, F Kibar, S Yavuz, O Kara, E Gurkan, S Paydas, HS Aksu, S Gulsah

Objective: This study is aimed to determine the local profile of blood culture isolates and changes in the susceptibility patterns to guide the antibiotic therapy in oncology andhaematology units.

Methods: Microbiologically documented hospital-acquired bloodstream infections were reviewed between 2005 - 2007 as a part of infection control surveillance in haematologyoncologydepartment of a university hospital.

Results: 194 microorganisms were isolated in 170 bloodstream infections episodes. Among these episodes, 79,1% (n=31), 80,9% (n=51) and 70,5% (n=48) were monomicrobialin years 2005, 2006 and 2007, respectively. Among the isolated 194 microorganisms, the ratio of the gram-negative bacteria were slightly increasing throughout these three years;68,9%, 70,4% and 77%, whereas the gram-positive bacteria were decreasing 31,1%, 23,9% and 19,2%, respectively and Candida species were the cause of 4 episodes (5,6%) in2006 and 3 episodes in 2007 (3,8%) (p>0.05). The majority of the cases were primary bloodstream infections. The most prevalent secondary cause of bacteremia was urinary tractinfections in year 2005 and 2007 and pneumonia in 2006. Extended spectrum beta lactamases (ESBL) rate among E.coli and Klebsiella spp. isolates were 69,6%, 40% and 79,2% inyears 2005, 2006 and 2007 respectively. Vancomycin resistance was high; 15/20 among Enterococcus species in the three years. The most effective agents against gram negativebacteria were aminoglycosides and carbapenems.

Conclusion: As a conclusion, gram negative microorganisms especially the Enterobacteriaecea are the major cause of bacteremia in haematology and oncology patients. Due tothe high resistance rates, antibiotic therapy should be selected strictly.