Health-care associated bacteremia in geriatric cancer patients with febrile neutropenia.

Abstract Objective The aim of this study was to determine the epidemiology, clinical manifestations, and outcome of health-care associated bacteremia in geriatric cancer patients with febrile neutropenia. Materials and Methods We retrospectively evaluated cancer patients with febrile neutropenia aged ≥ 60 years with culture proven health-care associated bacteremia between January 2005 and December 2011. The date of the first positive blood culture was regarded as the date of bacteremia onset. Primary outcome was the infection related mortality, defined as the death within 14 days of bacteremia onset. Results The two most common pathogens responsible for bacteremia were Staphylococcus epidermidis (36.1%) and Escherichia coli (31.5%), with high rates of methicillin resistance and extended-spectrum β-lactamase (ESBL) production, respectively. There were no statistically significant differences in infection related mortality rate according to the type of malignancy (p = 0.776). By the univariate analysis, factors associated with 14 day mortality among febrile neutropenic episodes were prolonged neutropenia (p = 0.024), persistent fever (p = 0.001), hospitalization in ICU (p  Conclusions The only independent risk factor for mortality was persistent fever. Although the most frequently isolated pathogens were S. epidermidis and E. coli , high rates of methicillin resistance and ESBL production were found respectively.