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Influence of Selective Bowel Decontamination on the Organisms Recovered During Bacteremia in Neutropenic Patients

  • Florian Daxboeck (a1), Werner Rabitsch (a2), Alexander Blacky (a1), Maria Stadler (a1), Paul A. Kyrle (a3), Alexander M. Hirschl (a4) and Walter Koller (a1)...

Abstract

Objective:

To assess the influence of prophylactic selective bowel decontamination (SBD) on the spectrum of microbes causing bloodstream infection (BSI).

Design:

The microbes causing BSI in neutropenic patients of a hematologic ward (HW) and a bone marrow transplantation unit (BMTU), respectively, were compared by retrospective analysis of blood culture results from January 1996 to June 2003.

Setting:

A 30-bed HW (no SBD) and a BMTU including a 7-bed normal care ward and an 8-bed intensive care unit (SBD used) of a 2,200-bed university teaching hospital.

Results:

The overall incidences of bacteremia in the HW and the BMTU were similar (72.6 vs 70.6 episodes per 1,000 admissions; P = .8). Two hundred twenty episodes of BSI were recorded in 164 neutropenic patients of the HW and 153 episodes in 127 neutropenic patients of the BMTU. Enterobacteriaceae (OR, 3.14; CI95, 1.67–5.97; P = .0002) and Streptococcus species (OR, 2.04; CI95, 1.14–3.70; P = .015) were observed more frequently in HW patients and coagulase-negative staphylococci more frequently in BMTU patients (OR, 0.15; CI95, 0.09–0.26; P< .00001). No statistically significant differences were found for gram-negative nonfermentative bacilli (P = .53), Staphylococcus aureus (P = .21), Enterococcus species (P = .48), anaerobic bacteria (P = .1), or fungi (P = .50).

Conclusions:

SBD did not lead to a significant reduction in the incidence of bacteremia, but significant changes in microbes recovered from blood cultures were observed. SBD should be considered when empiric antimicrobial therapy is prescribed for suspected BSI.

Copyright

Corresponding author

Clinical Institute of Hygiene and Medical Microbiology, Division of Hospital Hygiene, Vienna University Hospital, Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria

References

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1.Klastersky, J. Science and pragmatism in the treatment and prevention of neutropenic infection. J Antimicrob Chemother 1998;41(suppl D):1324.
2.Collin, B, Leather, HL, Wingard, JR, Ramphal, R. Evolution, incidence, and susceptibility of bacterial bloodstream isolates from 519 bone marrow transplant patients. Clin Infect Dis 2001;33:947953.
3.Brook, I, Frazier, EH. Infections caused by Propionibacterium species. Rev Infect Dis 1991;13:819822.
4.Wisplinghoff, H, Seifert, H, Wenzel, RP, Edmond, MB. Current trends in the epidemiology of nosocomial bloodstream infections in patients with hematological malignancies and solid neoplasms in hospitals in the United States. Clin Infect Dis 2003;36:11031110.
5.Edmond, MB, Wallace, SE, McClish, DK, Pfaller, MA, Jones, RN, Wenzel, RP. Nosocomial bloodstream infections in United States hospitals: a three-year analysis. Clin Infect Dis 1999;29:239244.
6.Gonzalez-Barca, E, Fernandez-Sevilla, A, Carratala, J, Granena, A, Gudiol, F. Prospective study of 288 episodes of bacteremia in neutropenic cancer patients in a single institution. Eur J Clin Microbiol Infect Dis 1996;15:291296.
7.Taylor, GD, Buchanan-Chell, M, Kirkland, T, McKenzie, M, Wiens, R. Trends and sources of nosocomial fungaemia. Mycoses 1994;37:187190.
8.Damaso, D, Moreno-Lopez, M, Martinez-Beltran, J, Garcia-Iglesias, MC. Susceptibility of current clinical isolates of Pseudomonas aeruginosa and enteric gram-negative bacilli to amikacin and other aminoglycoside antibiotics. J Infect Dis 1976;134(suppl):S390S394.
9.Murphy, ME, Sepkowitz, KA, Armstrong, D. Prevention of infections in patients with hematologic malignancy. In: Wiernik, PH, Canellos, GP, Dutcher, JP, Kyle, RA, eds. Neoplastic Diseases of the Blood, ed. 3. New York: Churchill Livingstone; 1995:10071025.
10.Koplan, JP, Hughes, JM, Jaffe, HW, et al.Recommendations of CDC, the Infectious Diseases Society of America, and the American Society of Blood and Marrow Transplantation. MMWR 2000;49(RR-10):1128.
11.Kirkpatrick, BD, Harrington, SM, Smith, D, et al.Outbreak of vancomycin-dependent Enterococcus faecium in a bone marrow transplant unit. Clin Infect Dis 1999;29:12681273.
12.Garrouste-Orgeas, M, Chevret, S, Mainardi, JL, Timsit, JF, Misset, B, Carlet, J. A one-year prospective study of nosocomial bacteraemia in ICU and non-ICU patients and its impact on patient outcome. J Hosp Infect 2000;44:206213.

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Influence of Selective Bowel Decontamination on the Organisms Recovered During Bacteremia in Neutropenic Patients

  • Florian Daxboeck (a1), Werner Rabitsch (a2), Alexander Blacky (a1), Maria Stadler (a1), Paul A. Kyrle (a3), Alexander M. Hirschl (a4) and Walter Koller (a1)...

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