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Nosocomial Infection in Malignancy Patients (Infeksi Nosokomial pada Penderita Keganasan)

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Cancer is an abnormal growth of cells which may result in the invasion of normal tissue or the spead to distant organs. There are numerous ways how cancer patients become immunocompromised, by the cancer it self, by radiotherapy and chemotherapy and by medical intervention e.g operation and catheterization. Current cancer therapy regimens have resulted in greater numbers of cancer patients achieving and maintaining remission but with more severe and prolonged period of immunocompromised state. These immunocompromised cancer patients usually are accompanied by nosocomial infections. The organism causing nosocomial infection changes according to the selection and the use of antibiotics. Infectious agents responsible for nosocomial infection usually are endogenous flora from gastrointestinal tract or hospital flora that already colonized the body surface. Hospital flora may also infect through other patients, hospital personel, food and air. Nosocomial infection in cancer patients is also a consequence of routine medical intervention e.g the use of vascular and urine catheter, the use of endotracheal tube and the excessive use of oral antimicrobial. Bacterial, fungal, viral and parasite organism may cause infection in neutropenic patients. The risk for bacterial infection increases when the neutrophil count falls below 500/L and become especially worse at neutrophil count below 100/L. There has been a shift in the microbial flora seen in may ancology centers during the past 10 to 15 years. Gram positive organism have replaced Gram negative bacilli as the leading cause of infection. As much as 40 percent infection in cancer patients are caused by endogenous flora and 40 percent by flora that have clonized the patients during hospitalization. Culture of the body surface is important, in case there is any infection direct antimicrobial therapy based on that culture can be administered. Speciments that are routinely taken from the body site are mouth and throat swab, sputum, nose swab, skin swab, wound and abscess. Blood, urine and stool. In the case of suspected infection caused by vascular catheter, culture from catheter tips are done.

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Majalah Kedokteran Indonesia,46(4)1996:190-202

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: ., 1996

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cross infection

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