Side Effect: Bacterial Infection

What is a bacterial bloodstream infection?

A bloodstream infection (BSI) is a serious medical condition that occurs when bacteria, viruses, fungi, or other organisms enter the bloodstream and cause an infection. A bloodstream infection caused specifically by one or more type of bacteria is called bacteremia, which can lead to sepsis. Sepsis is a systemic inflammation response and is potentially life-threatening if not treated promptly, especially in patients receiving certain types of chemotherapy who become immunocompromised.

What does a bloodstream infection look like?

Symptoms of a bloodstream infection can include fever, chills, rapid heartbeat, and shortness of breath. However, some patients may not show any specific symptoms, which can make diagnosis challenging.
 
The symptoms of sepsis due to a bloodstream infection can vary depending on the underlying cause, but may include fever, chills, rapid heartbeat, low blood pressure, confusion, and organ failure. Diagnosis typically involves blood cultures to identify the specific pathogen causing the infection.

Who gets bloodstream infections?

Patients with weakened immune systems, such as those undergoing chemotherapy or radiation therapy for cancer, are at increased risk for bloodstream infections. In fact, bloodstream infections are one of the leading causes of morbidity and mortality in cancer patients. Certain cancer treatments can damage the lining of the gastrointestinal tract and mucosal barriers, allowing bacteria to enter the bloodstream and cause infection. In addition, cancer patients often have central venous catheters or other medical devices that can serve as a site for infection. Patients with cancers that affect the bone marrow, such as certain types of leukemia and lymphoma, may be at higher risk if the cancer weakens the immune system.

How do you prevent bacteria bloodstream infection in patients with cancer?

Preventing bacteria bloodstream infections in cancer patients requires a multilayered approach, which often includes strict adherence to infection control practices such as hand hygiene, sterile technique by the doctors during invasive procedures such as surgery or placement of IV lines. Additionally, since foreign objects can serve as a nidus for infection, the prompt removal of indwelling devices when they are no longer needed may help from preventing infections from developing. Importantly, prophylactic antibiotics and immunizations may be recommended for certain high-risk patients, so it is important to ask your doctor if you qualify for these.

How do you treat a bloodstream bacteria infection in cancer patients?

When bacteremia is suspected, doctors usually take a blood sample and send it for culture before starting an antibiotic. The treatment of bloodstream infections is started promptly thereafter, which often includes administration of intravenous broad-spectrum antibiotics while awaiting the results of blood cultures. Oral antibiotics may be used in certain circumstances as determined by your doctor.
Bacteria often require 1-2 days to grow from the blood sample sent to the lab to a point where they can be identified. Once the specific type of bacteria is known, the antibiotic regimen can be tailored to the organism's sensitivity profile. The dose and frequency of the antibiotic prescribed may depend upon your kidney and liver function, as well as other medications you are taking, and of course, whether you have a pre-existing drug allergy to specific antibiotics.
 
It is important to note that certain pathogens, such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE), may require alternative antibiotics and more aggressive treatment.
 
Treatment of bloodstream infections in cancer patients may also involves a combination of antibiotics and supportive care, such as IV fluids to help keep your blood pressure up, and oxygen therapy to keep your blood oxygen saturation (often referred to as the “O2 sat”) levels above 90%.
 
Studies have been conducted to investigate the incidence, risk factors, and management of bloodstream infections in patients with cancer. In general, bloodstream infections are more common in patients with hematological malignancies and that the use of central venous catheters was a significant risk factor for infection.