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Opportunistic infections in cancer patients

Year 2008, Volume: 23 Issue: 3, 153 - 162, 01.04.2008

Abstract

Infections are the most common complication and major cause of morbidity and mortality in patients with cancer. Fever remains the only indicator of infection in this group of patients. The list of potential pathogens includes both conventional microorganisms and opportunistic agents. The epidemiological pattern of infections in patients with cancer is influenced by the following factors: 1) the severity and duration of neutropenia, 2) the nature of antineoplastic therapy, 3) host related factors, 4) the use of chemoprophylaxis and/or empirical antibiotic therapy, 5) the use of external medical devices such as central venous catheters, 6) environmental factors, and 7) duration of hospital stay. This article will focus on current challenges associated with opportunistic infections.

References

  • . Smiley S, Almyroudis N, Segal BH. Epidemiology and management of opportunistic infections in immunocompromised patients with cancer. Abstr Hematol Oncol 2005;8(3):20-30.
  • 2. Akova M. ‹mmünkompromize konakç›da infeksiyonl a r. w w w. m e d i n f o . h a c e t t e p e . e d u . t r / D e r s / Tr / D 3 / 1 / 1386.doc.
  • 3. Rolston KV. The Infectious Diseases Society of America 2002 guidelines for the use of antimicrobial agents in patients with cancer and neutropenia: salient features and comments. Clin Infect Dis 2004;39 Suppl 1:S44-8.
  • 4. Rolston KV. Challenges in the treatment of infections caused by gram-positive and gram-negative bacteria in patients with cancer and neutropenia. Clin Infect Dis 2005;40 Suppl 4:S246-52.
  • 5. Klastersky J, Aoun M. Opportunistic infections in patients with cancer. Ann Oncol 2004;15 Suppl 4:iv329-35.
  • 6. Ramphal R. Changes in the etiology of bacteremia in febrile neutropenic patients and the susceptibilities of the currently isolated pathogens. Clin Infect Dis 2004;39 Suppl 1:S25-31.
  • 7. Ascioglu S, Rex JH, de Pauw B, Bennett JE, Bille J, Crokaert F, et al. Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis 2002;34(1):7- 14.
  • 8. Simon DM, Levin S. Infectious complications of solid organ transplantations. Infect Dis Clin North Am 2001;15(2):521-49.
  • 9. Legendre AM, Rohrbach BW, Toal RL, Rinaldi MG, Grace LL, Jones JB. Treatment of blastomycosis with itraconazole in 112 dogs. J Vet Intern Med 1996;10(6):365-71.
  • 10. Thaler M, Pastakia B, Shawker TH, O’Leary T, Pizzo PA. Hepatic candidiasis in cancer patients: the evolving picture of the syndrome. Ann Intern Med 1988;108(1):88-100.
  • 11. Flannery MT, Simmons DB, Saba H, Altus P, Wallach PM, Adelman HM. Fluconazole in the treatment of hepatosplenic candidiasis. Arch Intern Med 1992;152(2):406-8.
  • 12.Redline RW, Dahms BB. Malassezia pulmonary vasculitis in an infant on long-term Intralipid therapy. N Engl J Med 1981;305(23):1395-8.
  • 13. Evans HL, Kletzel M, Lawson RD, Frankel LS, Hopfer RL. Systemic mycosis due to Trichosporon cutaneum: a report of two additional cases. Cancer 1980;45(2):367-71.
  • 14. Heney C, Greeff M, Davis V. Hickman catheter-related protothecal algaemia in an immunocompromised child. J Infect Dis 1991;163(4):930-1.
  • 15.Jacobson MA, Hahn SM, Gerberding JL, Lee B, Sande MA. Ciprofloxacin for Salmonella bacteremia in the acquired immunodeficiency syndrome (AIDS). Ann Intern Med 1989;110(12):1027-9.
  • 16. Dan M, Somer I, Knobel B, Gutman R. Cutaneous manifestations of infection with Corynebacterium group JK. Rev Infect Dis 1988;10(6):1204-7.
  • 17. Lipsky BA, Goldberger AC, Tompkins LS, Plorde JJ. Infections caused by nondiphtheria corynebacteria. Rev Infect Dis 1982;4(6):1220-35.
  • 18. Attal M, Schlaifer D, Rubie H, Huguet F, Charlet JP, Bloom E, et al. Prevention of gram-positive infections after bone marrow transplantation by systemic vancomycin: a prospective, randomized trial. J Clin Oncol 1991;9(5):865-70.
  • 19. Gerson SL, Talbot GH, Hurwitz S, Strom BL, Lusk EJ, Cassileth PA. Prolonged granulocytopenia: the major risk factor for invasive pulmonary aspergillosis in patients with acute leukemia. Ann Intern Med 1984;100(3):345-51.
  • 20.Conneally E, Cafferkey MT, Daly PA, Keane CT, McCann SR. Nebulized amphotericin B as prophylaxis against invasive aspergillosis in granulocytopenic patients. Bone Marrow Transplant 1990;5(6):403-6.
  • 21. Newsome GS, Ward DJ, Pierce PF. Spontaneous pneumothorax in patients with acquired immunodeficiency syndrome treated with prophylactic aerosolized pentamidine. Arch Intern Med 1990;150(10):2167-8.
  • 22.Raviglione MC. Extrapulmonary pneumocystosis: the first 50 cases. Rev Infect Dis 1990;12(6):1127-38. 23. Meyers JD. Infection in bone marrow transplant recipients. Am J Med 1986;81(1A):27-38.
  • 24. Krilov LR, Rubin LG, Frogel M, Gloster E, Ni K, Kaplan M, et al. Disseminated adenovirus infection with hepatic necrosis in patients with human immunodeficiency virus infection and other immunodeficiency states. Rev Infect Dis 1990;12(2):303-7.
  • 25.Ramsey PG, Fife KH, Hackman RC, Meyers JD, Corey L. Herpes simplex virus pneumonia: clinical, virologic, and pathologic features in 20 patients. Ann Intern Med 1982;97(6):813-20.
  • 26. Kaplan MH, Armstrong D, Rosen P. Tuberculosis complicating neoplastic disease. A review of 201 cases. Cancer 1974;33(3):850-8.
  • 27.Berkey P, Bodey GP. Nocardial infection in patients with neoplastic disease. Rev Infect Dis 1989;11(3):407-12.
  • 28. Harvey RL, Sunstrum JC. Rhodococcus equi infection in patients with and without human immunodeficiency virus infection. Rev Infect Dis 1991;13(1):139-45.
  • 29. Kaplan MH, Rosen PP, Armstrong D. Cryptococcosis in a cancer hospital: clinical and pathological correlates in forty-six patients. Cancer 1977;39(5):2265-74.
  • 30. Farber JM, Peterkin PI. Listeria monocytogenes, a food-borne pathogen. Microbiol Rev 1991;55(3):476- 511

Kanser hastalarında fırsatçı enfeksiyonlar

Year 2008, Volume: 23 Issue: 3, 153 - 162, 01.04.2008

Abstract

Enfeksiyonlar kanser hastalarında mortalite ve morbiditeyi etkileyen en önemli faktörlerin başında gelmektedir. Ateş, çoğu zaman bu tip hastalardaki tek somut belirti olabilmektedir. Enfeksiyona yol açan etkenlerin listesi ise her geçen gün uzamaktadır; konvansiyonel mikroorganizmalara fırsatçı ajanlarda eklenmektedir. Enfeksiyon epidemiyolojisi bir takım faktörlerden etkilenmektedir, şöyle ki; (1) nötropeni şiddeti ve süresi, (2) seçilen antineoplastik tedavi, (3) konağa bağlı faktörler, (4) kemoproflaksi ve ampirik antibiyotik tedavisi, (5) santral venöz katater kullanımı, (6) çevresel faktörler (7) hastanede kalma süresi. Bu makalede amaç dikkati bu konuya çekmektir.

References

  • . Smiley S, Almyroudis N, Segal BH. Epidemiology and management of opportunistic infections in immunocompromised patients with cancer. Abstr Hematol Oncol 2005;8(3):20-30.
  • 2. Akova M. ‹mmünkompromize konakç›da infeksiyonl a r. w w w. m e d i n f o . h a c e t t e p e . e d u . t r / D e r s / Tr / D 3 / 1 / 1386.doc.
  • 3. Rolston KV. The Infectious Diseases Society of America 2002 guidelines for the use of antimicrobial agents in patients with cancer and neutropenia: salient features and comments. Clin Infect Dis 2004;39 Suppl 1:S44-8.
  • 4. Rolston KV. Challenges in the treatment of infections caused by gram-positive and gram-negative bacteria in patients with cancer and neutropenia. Clin Infect Dis 2005;40 Suppl 4:S246-52.
  • 5. Klastersky J, Aoun M. Opportunistic infections in patients with cancer. Ann Oncol 2004;15 Suppl 4:iv329-35.
  • 6. Ramphal R. Changes in the etiology of bacteremia in febrile neutropenic patients and the susceptibilities of the currently isolated pathogens. Clin Infect Dis 2004;39 Suppl 1:S25-31.
  • 7. Ascioglu S, Rex JH, de Pauw B, Bennett JE, Bille J, Crokaert F, et al. Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis 2002;34(1):7- 14.
  • 8. Simon DM, Levin S. Infectious complications of solid organ transplantations. Infect Dis Clin North Am 2001;15(2):521-49.
  • 9. Legendre AM, Rohrbach BW, Toal RL, Rinaldi MG, Grace LL, Jones JB. Treatment of blastomycosis with itraconazole in 112 dogs. J Vet Intern Med 1996;10(6):365-71.
  • 10. Thaler M, Pastakia B, Shawker TH, O’Leary T, Pizzo PA. Hepatic candidiasis in cancer patients: the evolving picture of the syndrome. Ann Intern Med 1988;108(1):88-100.
  • 11. Flannery MT, Simmons DB, Saba H, Altus P, Wallach PM, Adelman HM. Fluconazole in the treatment of hepatosplenic candidiasis. Arch Intern Med 1992;152(2):406-8.
  • 12.Redline RW, Dahms BB. Malassezia pulmonary vasculitis in an infant on long-term Intralipid therapy. N Engl J Med 1981;305(23):1395-8.
  • 13. Evans HL, Kletzel M, Lawson RD, Frankel LS, Hopfer RL. Systemic mycosis due to Trichosporon cutaneum: a report of two additional cases. Cancer 1980;45(2):367-71.
  • 14. Heney C, Greeff M, Davis V. Hickman catheter-related protothecal algaemia in an immunocompromised child. J Infect Dis 1991;163(4):930-1.
  • 15.Jacobson MA, Hahn SM, Gerberding JL, Lee B, Sande MA. Ciprofloxacin for Salmonella bacteremia in the acquired immunodeficiency syndrome (AIDS). Ann Intern Med 1989;110(12):1027-9.
  • 16. Dan M, Somer I, Knobel B, Gutman R. Cutaneous manifestations of infection with Corynebacterium group JK. Rev Infect Dis 1988;10(6):1204-7.
  • 17. Lipsky BA, Goldberger AC, Tompkins LS, Plorde JJ. Infections caused by nondiphtheria corynebacteria. Rev Infect Dis 1982;4(6):1220-35.
  • 18. Attal M, Schlaifer D, Rubie H, Huguet F, Charlet JP, Bloom E, et al. Prevention of gram-positive infections after bone marrow transplantation by systemic vancomycin: a prospective, randomized trial. J Clin Oncol 1991;9(5):865-70.
  • 19. Gerson SL, Talbot GH, Hurwitz S, Strom BL, Lusk EJ, Cassileth PA. Prolonged granulocytopenia: the major risk factor for invasive pulmonary aspergillosis in patients with acute leukemia. Ann Intern Med 1984;100(3):345-51.
  • 20.Conneally E, Cafferkey MT, Daly PA, Keane CT, McCann SR. Nebulized amphotericin B as prophylaxis against invasive aspergillosis in granulocytopenic patients. Bone Marrow Transplant 1990;5(6):403-6.
  • 21. Newsome GS, Ward DJ, Pierce PF. Spontaneous pneumothorax in patients with acquired immunodeficiency syndrome treated with prophylactic aerosolized pentamidine. Arch Intern Med 1990;150(10):2167-8.
  • 22.Raviglione MC. Extrapulmonary pneumocystosis: the first 50 cases. Rev Infect Dis 1990;12(6):1127-38. 23. Meyers JD. Infection in bone marrow transplant recipients. Am J Med 1986;81(1A):27-38.
  • 24. Krilov LR, Rubin LG, Frogel M, Gloster E, Ni K, Kaplan M, et al. Disseminated adenovirus infection with hepatic necrosis in patients with human immunodeficiency virus infection and other immunodeficiency states. Rev Infect Dis 1990;12(2):303-7.
  • 25.Ramsey PG, Fife KH, Hackman RC, Meyers JD, Corey L. Herpes simplex virus pneumonia: clinical, virologic, and pathologic features in 20 patients. Ann Intern Med 1982;97(6):813-20.
  • 26. Kaplan MH, Armstrong D, Rosen P. Tuberculosis complicating neoplastic disease. A review of 201 cases. Cancer 1974;33(3):850-8.
  • 27.Berkey P, Bodey GP. Nocardial infection in patients with neoplastic disease. Rev Infect Dis 1989;11(3):407-12.
  • 28. Harvey RL, Sunstrum JC. Rhodococcus equi infection in patients with and without human immunodeficiency virus infection. Rev Infect Dis 1991;13(1):139-45.
  • 29. Kaplan MH, Rosen PP, Armstrong D. Cryptococcosis in a cancer hospital: clinical and pathological correlates in forty-six patients. Cancer 1977;39(5):2265-74.
  • 30. Farber JM, Peterkin PI. Listeria monocytogenes, a food-borne pathogen. Microbiol Rev 1991;55(3):476- 511
There are 29 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Özlem Alıcı This is me

Enver Akbaş This is me

Süleyman Alıcı This is me

Publication Date April 1, 2008
Published in Issue Year 2008 Volume: 23 Issue: 3

Cite

APA Alıcı, Ö., Akbaş, E., & Alıcı, S. (2008). Kanser hastalarında fırsatçı enfeksiyonlar. Türk Onkoloji Dergisi, 23(3), 153-162.
AMA Alıcı Ö, Akbaş E, Alıcı S. Kanser hastalarında fırsatçı enfeksiyonlar. Türk Onkoloji Dergisi. April 2008;23(3):153-162.
Chicago Alıcı, Özlem, Enver Akbaş, and Süleyman Alıcı. “Kanser hastalarında fırsatçı Enfeksiyonlar”. Türk Onkoloji Dergisi 23, no. 3 (April 2008): 153-62.
EndNote Alıcı Ö, Akbaş E, Alıcı S (April 1, 2008) Kanser hastalarında fırsatçı enfeksiyonlar. Türk Onkoloji Dergisi 23 3 153–162.
IEEE Ö. Alıcı, E. Akbaş, and S. Alıcı, “Kanser hastalarında fırsatçı enfeksiyonlar”, Türk Onkoloji Dergisi, vol. 23, no. 3, pp. 153–162, 2008.
ISNAD Alıcı, Özlem et al. “Kanser hastalarında fırsatçı Enfeksiyonlar”. Türk Onkoloji Dergisi 23/3 (April 2008), 153-162.
JAMA Alıcı Ö, Akbaş E, Alıcı S. Kanser hastalarında fırsatçı enfeksiyonlar. Türk Onkoloji Dergisi. 2008;23:153–162.
MLA Alıcı, Özlem et al. “Kanser hastalarında fırsatçı Enfeksiyonlar”. Türk Onkoloji Dergisi, vol. 23, no. 3, 2008, pp. 153-62.
Vancouver Alıcı Ö, Akbaş E, Alıcı S. Kanser hastalarında fırsatçı enfeksiyonlar. Türk Onkoloji Dergisi. 2008;23(3):153-62.