ABSTRACT
OVERVIEW There are numerous causes of infection of the genitourinary tract in cancer patients. Hematological abnormalities, chemotherapy, and compromise ofanatomical barriers increase the susceptibility to infection. Although the pathogens are similar to those of the immunocompetent host, infections generally are more frequent and more severe. One study focusing on epidemiology ofbacteremia in neutropenic patients showed a urinary tract focus in 25% ofpatients [I].
URINARY TRACT INFECTION Urinary tract infections (UTI) occur when normal defence barriers are altered. These include normal perineal flora, loss of micturition ability, and the presence of indwelling devices such as Foley catheters and ureteral stents that
often introduce colonizing flora [2]. The presence of an indwelling urinary catheter increases the risk of bacteruria 5 to 10% for each day of catheterization [3]. The most common organisms responsible for these infections are Escherichia coli, Pseudomonas aeruginosa, Serratia marcessans, Staphylococcus aureus, and Candida albicans [4,5). Systemic antibiotics that alter the normal genitourinary flora may lead to overgrowth of hospital-acquired and often resistant bacteria such as P. aeruginosa and C. albicans [6]. In most cases of bladder colonization with C. albicans or other yeast due to the presence of an indwelling catheter, removal of the catheter is usually sufficient to relieve colonization and symptoms. In some cases, however, fungus balls may develop in the bladder or renal pelvis leading to persistent funguria.
