[Current trends in the epidemiology of bloodstream infections in patients with hematological malignancies and solid neoplasms].

OBJECTIVES: to characterize the epidemiological and microbiological spectrum of systemic infections in hematological and oncological patients.

METHOD: a prospective study of bloodstream infections was conducted between May 2004-December 2005 in two hospitals from Iaşi.

RESULTS: We investigated a total of 86 suspected episodes of systemic infections that occurred in 76 selected patients, 40 males and 36 females (average age = 26 years old). There were 39 (45.35%) febrile episodes with positive blood culture and 47 (54.65%) with negative blood culture. The most common microorganisms were gram-positive cocci 12 (30.76%), followed by stable cell-wall deficient forms 9 (23.07%), gram-negative bacteria 7 (17.95%), gram-positive bacteria 5 (12.82%), fungi 4 (10.25%), and anaerobes 2 (5%). From the total of 23 cell-wall deficient form strains (58.97%), 14 returned to their typical morphology (6 gram-positive cocci, 5 gram-positive bacilli, 3 gram-negative bacilli) and 9 were L-stable.

CONCLUSIONS: 1) The isolation rate of 45.5% was in accordance with literature reports; similar percentages of gram-positive and gram-negative isolates were found (the shift from predominating gram-negative to a gram-positive etiology was noted). 2) A high proportion of cell wall deficient forms was found, rarely reported in previous studies. 3) Studies reporting local microbiological findings are necessary because they support an initial empiric antibiotic regimens for prophylaxis or therapy more accurately than from other areas. The right treatment protocols remain to be established.