Etiology of bacteraemia in patients with various malignancies: is there association between certain antineoplastic drugs and microorganism?

The authors studied a relationship between particular bacterial or fungal organisms isolated from blood cultures and type of malignancy and antineoplastic drugs in 237 cancer patients. Sixty four had acute myelogenous leukemia (AML), 43 non-Hodgkin's lymphoma (NHL) and 140 solid tumors (ST). All patients had at least one positive blood cultures for one or more microorganism drawn during 1-10 days after cytotoxic chemotherapy, viridans streptococcal bacteremia was more frequently observed in patients with AML (12.5%) and NHL (27.9%) than ST (43%, p < 0.01 and 0.03). The incidence of anaerobic bacteria was similar in patients with NHL and ST, and in both groups significantly higher (p < 0.05) than in AML. Enterobacteriaceae caused bacteremia less frequently in patients with AML than in those with ST (12.5 vs 27.8%, p < 0.05). However, the highest incidence of Stenotrophomonas maltophilia bacteremia was seen in patients with AML (6.3% vs 2.3%, p < 0.04 and 0.03). Concerning fungemia, Candida albicans occurred significantly more frequently in blood cultures in patients with NHL, and molds in patients with AML. Cytarabine and metothrexate seems to be more frequently associated with viridans streptococci, cytarabine and mitoxanthrone with Stenotrophomonas maltophilia, B. fragilis with cisplatin and 5-fluorouracil, Fusarium spp., Mucorales and Aspergillus spp. with acute leukaemia (AL) treated with cytarabine and mitoxantrone. The association of other pathogens with an underlying disease or chemotherapeutic regimen could not be documented. (Tab. 1, Ref. 19.).