Acute leukemia and infections: perspectives from a general hospital.

The incidence and etiology of infections in 210 acute leukemics at the University of Mississippi Medical Center between 1962 and 1978 were reviewed. Infections episodes occurred 269 times in 148 patients. In 193 infections, potential pathogens were cultured. Infection was a contributing cause of death in 89 patients. E. Coli, S. aureus, K. pneumoniae, and P. aeruginosa accounted for 58% of the isolates. No unusual patterns of antimicrobial resistance were observed. The outcome of the infections was related to the absence or resolution of neutropenia. Among 48 patients febrile on first admission, four cases of gram-negative pneumonia, two cases of fungal pneumonia, and two cases of pseudomonas cellulitis were diagnosed. We conclude that the etiology of infections was similar to that of cancer centers; multidrug-resistant gram-negative organisms were not prevalent; absence or resolution of neutropenia indicates a good prognosis for outcome of infection; and untreated acute leukemics may acquire opportunistic infections.