Bacteremia due to Staphylococcus aureus in patients with cancer: report on 45 cases in adults and review of the literature.

The frequency, predisposing factors, therapy, and outcome of 45 episodes of bacteremia due to Staphylococcus aureus were reviewed in adult cancer patients. A poor performance status (i.e., patients largely bedridden), progressive neoplastic disease, and compromise of the mucocutaneous defense barriers characterized the patients with S. aureus sepsis. Seventeen patients died soon after the onset of infection: seven (16%) as direct result of staphylococcal sepsis, seven of factors unrelated to infection, and three of secondary sepsis due to gram-negative bacilli. The data presented here and reported by others indicated that (1) the incidence of staphylococcal sepsis in cancer patients has recently increased from a low point of 5% to a level as high as 30%; (2) breaches in the epithelium are the most important factors determining risk; (3) there are three effective approaches to therapy depending upon the clinical setting; and (4) the outcome appears to be determined by the status of the neoplastic disease and by early institution of appropriate antimicrobial therapy.