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Bloodstream infection risk high in ICU gynecologic cancer patients

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2011 ICAAC

CHICAGO — Patients with gynecologic cancer admitted to intensive care units were at higher risk for microbiological-confirmed hospital-acquired bloodstream infections when compared with those admitted to the clinical ward, according to 8-year data presented here.

“However, data raise concern for patients admitted to [clinical wards]; especially those with hemodialysis catheter,” according to Ianick Souto Martins, MD, professor at Fluminense Federal University in Rio de Janeiro, Brazil, and colleagues.

As research on bloodstream infections in patients with gynecologic cancer is rare, the researchers set out to examine active surveillance in clinical wards and ICUs between 2002 and 2009 and assessed case-series of microbiological-confirmed hospital-acquired bloodstream infections in this patient population.

A total of 198 cases were identified. Compared with an infection incidence density of 1.5/1,000 patient-days in the clinical ward, incidence was significantly higher among those in the ICU (3.2/1,000 patient-days).

Overall, 63% of cases were classified as primary bloodstream infections — 87% of which were associated with vascular catheter; 23.7% with central-venous line; and 24.2% with hemodialysis catheter. Of the 34% of cases classified as secondary bloodstream infections, 54% were associated with urinary tract infections (UTIs).

Further, among 213 bacteria detected, 25% were Staphylococcus aureus. This was followed by Escherichia coli (13%), Pseudomonas aeruginosa (11%) and Klebsiella pneumoniae (9%). Fifteen percent were multidrug-resistant.

“These findings suggest that measures for bloodstream infections control should focus on preventable events such as vascular catheter bloodstream infections,” according to the researchers. “UTI was an important cause of secondary bloodstream infections, which might be related to anatomic anomalies of the urinary tract due to gynecologic cancer.”

For more information:

• Martins IS. # K-828. Presented at: the 2011ICAAC; Sept. 17-20; Chicago.

Disclosure: The researchers report no relevant financial disclosures.

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