Changing patterns of infections in the immunocompromised patient with cancer.

Infectious complications have become frequent causes of morbidity and mortality in cancer patients, often replacing the primary disease as the leading cause of death. Intensive chemotherapy regimens, widespread prophylactic and therapeutic administration of antibiotics, and reliance on intravascular catheters have altered the epidemiology of infections in these patients. The authors review how gram-positive bacteremias have replaced gram-negative bacteremias as the leading causes of infections in many patients with cancer, and how fungal infections have become a leading cause of morbidity and mortality as bacterial infections are better controlled. Multiresistant organisms that have developed during the past decade and future trends in infectious complications of cancer patients are also discussed.