16027 Background: As a result of the improvement in oncological treatments, MPCA could arise as a more frequent problem in Public Health. The purpose of this retrospective review was to estimate both the incidence and medical features of MPCA pts treated at the Instituto Oncológico Henry Moore (IOHM). Methods: We analyzed 17,100 medical charts from our database since 1987 and identified 378 MPC (2,21%). Then we retrieved data over the last eight years (1997–2005). Those pts with at least two second primary tumors were included in this analysis. They were categorized as synchronous (second tumor diagnosis within the first six months from the first one) and metachronous (all the remaining). Pts with skin cancer different from melanoma were excluded. Results: One hundred and seventy eight (M:73; F:105) out of 8,500 cancer pts (2.09%) had at least two primary cancers. Median age was 59, 64 and 68 yo at the moment of the first, second and third diagnosis, respectively. In 138 (78%) pts, the diagnosis of the second cancer was suspected by clinical findings, while in 40 (22%) pts, it was discovered because of medical screening in an otherwise asymptomatic pt. (See Table below) The most frequent site combination was breast-breast (n = 21). A total of 57 pts (32%) had a family history of oncologic diseases. With a median follow-up of 31 mo (range: 0,57–311) after the second cancer diagnosis, 127 pts are still alive (71,35%) and 51 (28,65%) are dead. Conclusions: In the last eight years, 178 (2.09%) pts had developed MPC, being breast, prostate, colon and lung the most frequent (first and later) localizations, and breast-breast the most frequent site combination. The so-called “screening effect” seems to have a low impact on the studied population. [Table: see text] No significant financial relationships to disclose.

Financiamiento: Este estudio no tuvo financiamiento. Los autores no poseen conflictos de interés.

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Background Enterococcus spp. (E) is an important cause of nosocomial bacteremia. The emergence of vancomycin-resistant E in the nosocomial setting conditions the empirical treatment and limits therapeutic options.MethodsA retrospective cohort study of children ≥1 month with E bacteremia in a reference pediatric hospital was performed. Study period January 1, 2016–December 31, 2018. Outcome: to describe clinical and epidemiological characteristics of children with bacteremia due to Enterococcus spp. resistant to vancomycin (VRE) vs. sensitive (VSE). Identify variables associated with VRE. STATA 13 was used.Results N = 82 patients. Median age was 37.6 months (IQR 2–48), 45 patients (54.9%) were male; 76 patients (92.7%) had underlying disease (intestinal failure (21.9%), heart disease (17.1%), preterm births (12.2%), hematological disease (10.9%), and liver failure (7.3%); 16 patients (19.5%) received immunosuppressive therapy. Sixty bacteremia (73.2%) were by E. faecalis and 22 (26, 8%) by E. faecium. Vancomycin resistance was documented in 13 patients (15.8%), all of which were E. faecium. In the bivariate analysis, patients with VRE bacteremia were significantly older in months than those with VSE bacteremia [75.4 (IQR 6–151) vs. 30.5 (IQR 2–33), P <0.02]; had more frequency of previous colonization with VRE [n: 8 (61.5%) vs. n: 4 (5.8%) P < 0.001], hematological disease [n: 5 (38.5%) vs. n: 5 (5.8%), P = 0.01], liver failure [n: 3 (23.1%) vs. n: 3 (4.4%), P = 0.02] and immunosuppressive therapy [n: 6 (46.2%) vs. n: 10 (14.5%) P = 0.008]. Patients with VRE bacteremia had a lower median white blood cell count [7040 (IQR 2150–10250) vs. 14474 (IQR 6160–17090), P <0.03]. Mortality in P with VRE was 15.4% (n: 2) and 4.3% in P with VSE (n: 3), P = 0.1. No statistically significant differences were found according to history of surgery, previous hospitalization, antibiotic therapy in the last 3 months or clinical presentation. In the multivariate model, predictors of VRE bacteremia adjusted for the rest of the significant variables were hematological disease OR 11.1 (95% CI 2.3–53.8) P = 0.003, and liver failure OR 7.7 (95% CI 1.2–50.4), P = 0.03.ConclusionIn this cohort of children with enterococcal bacteremia, hematological disease and liver failure were predictive variables of VRE bacteremia.Disclosures All authors: No reported disclosures.