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Bacteremia and fungemia in the immunocompromised patient

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Abstract

Considerable changes have occurred during the 1980s in the clinical nature and diagnosis of bacteremia and fungemia in the immunocompromised patient. Cancer patients with prolonged neutropenia, many with indwelling catheters, and AIDS patients with both T-cell and B-cell deficiencies have changed the spectrum of organisms causing septicemia. There has been a shift to infection with gram-positive bacteria, including mycobacteria, and water-borne organisms, includingAcintobacter spp. andPseudomonas spp. New blood culture systems, including a lysis-centrifugation system and radiometric methods utilizing resin broth media, remove antagonistic antimicrobial agents, and the lysis-centrifugation system routinely provides quantitation of organisms from the blood. Quantitation has been used to identify sources of infection, to differentiate contamination from true infection, and to monitor the course of antibiotic treatment.

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References

  1. Singer, C., Kaplan, M. H., Armstrong, D.: Bacteremia and fungemia complicating neoplastic disease. American Journal of Medicine 1977, 62: 731–742.

    Google Scholar 

  2. Whimbey, E., Kiehn, T. E., Brannon, P., Blevins, A., Armstrong, D.: Bacteremia and fungemia in patients with neoplastic disease. American Journal of Medicine 1987, 82: 723–730.

    Google Scholar 

  3. Pizzo, P. A., Ladisch, S., Simon, R. M., Gill, F., Levine, A. S.: Increasing incidence of gram-positive sepsis in cancer patients. Medical Pediatric Oncology 1978, 5: 241–244.

    Google Scholar 

  4. Lowder, J. N., Lazarus, H. M., Herzig, R. H.: Bacteremias and fungemias in oncologic patients with central venous catheters. Archives of Internal Medicine 1982, 142: 1456–1473.

    Google Scholar 

  5. Bodey, G. P., Nies, B. A., Freireich, E. J.: Multiple organism septicemia in acute leukemia. Archives of Internal Medicine 1965, 116: 266–272.

    Google Scholar 

  6. Kiehn, T. E., Wong, B., Edwards, F. F., Armstrong, D.: Comparative recovery of bacteria and yeasts from lysis-centrifugation and a conventional blood culture system. Journal of Clinical Microbiology 1983, 18: 300–304.

    Google Scholar 

  7. Kiehn, T. E., Edwards, F. F., Brannon, P., Tsang, A. Y., Maio, M., Gold, J. W. M., Whimbey, E., Wong, B., McClatchy, J. K., Armstrong, D.: Infections caused byMycobacterium avium complex in immunocompromised patients: diagnosis by blood culture and fecal examination, antimicrobial susceptibility tests, and morphological and seroagglutination characteristics. Journal of Clinical Microbiology 1985, 21: 168–173.

    Google Scholar 

  8. Whimbey, E., Gold, J. W. M., Polsky, B., Dryjanski, J., Hawkins, C., Blevins, A., Brannon, P., Kiehn, T. E., Brown, A. E., Armstrong, D.: Bacteremia and fungemia in patients with the acquired immunodeficiency syndrome. Annals of Internal Medicine 1986, 104: 511–514.

    Google Scholar 

  9. Kern, W., Vanek, E.:Aerococcus bacteremia associated with granulocytopenia. European Journal of Clinical Microbiology 1987, 6: 670–673.

    Google Scholar 

  10. Gandola, C., Butler, T., Badger, S., Cheng, E., Beard, S.: Septicemia caused byCapnocytophaga in a granulocytopenic patient with glossitis. Archives of Internal Medicine 1980, 140: 851–852.

    Google Scholar 

  11. Nachamkin, I., Stowell, C., Skalina, D., Jones, A. M., Hoop, R. M., Smibert, R. M.:Campylobacter laridis causing bacteremia in an immunosuppressed patient. Annals of Internal Medicine 1984, 101: 55–57.

    Google Scholar 

  12. Dan, M., Berger, S. A., Aderka, D., Levo, Y.: Septicemia caused by the gram-negative bacterium CDC IV c-2 in an immunocompromised human. Journal of Clinical Microbiology 1986, 23: 803.

    Google Scholar 

  13. Hirsh, B. E., Wong, B., Kiehn, T. E., Gee, T., Armstrong, D.:Flavobacterium meningosepticum bacteremia in an adult with acute leukemia: use of rifampin to clear persistent infection. Diagnostic Microbiology and Infectious Diseases 1986, 4: 64–69.

    Google Scholar 

  14. Garcia, C. R., Johnston, B. L., Corvi, G., Walker, L. J., George, W. L.: Intravenous catheter-associatedMalassezia furfur fungemia. American Journal of Medicine 1987, 83: 790–792.

    Google Scholar 

  15. Friis, H., Plesner, A., Scheibel, J., Justesen, T., Lind, K.:Mycoplasma hominis septicaemia. British Medical Journal 1983, 286: 2013–2014.

    Google Scholar 

  16. Schifman, R. B., Ryan, K. J.:Neisseria lactamica septicemia in an immunocompromised patient. Journal of Clinical Microbiology 1983, 17: 934–935.

    Google Scholar 

  17. Pinon, G., Grollier, G., Romet-Lemonne, J. L., de Rautlin de al Roy, Y.: FatalSelenomonas sputigena septicemia probably originating from lung abscess. European Journal of Clinical Microbiology 1985, 4: 343–344.

    Google Scholar 

  18. Freney, J., Hansen, W., Ploton, C., Meugnier, H., Madier, S., Bornstein, N., Fleurette, J.: Septicemia caused bySphingobacterium mulitvorum. Journal of Clinical Microbiology 1987, 25: 1126–1128.

    Google Scholar 

  19. Janda, J. M., Brenden, R., DeBenedetti, J. A., Constantino, M. O., Robin, T.:Vibrio alginolyticus bacteremia in an immunocompromised patient. Diagnostic Microbiology and Infectious Diseases 1986, 5: 337–340.

    Google Scholar 

  20. Tegtmeier, B. R., Vice, J. L.: Evaluation of the Bactec 16B medium in a cancer hospital. American Journal of Clinical Pathology 1984, 81: 783–786.

    Google Scholar 

  21. Hopfer, R. L., Moore, D. G., Fainstein, V., Watkins, S., Wenglar, M.: Routine use of Bactec 16B bottles to remove antibacterial and antitumor agents from blood cultures of cancer patients. Journal of Clinical Microbiology 1983, 18: 759–764.

    Google Scholar 

  22. Brannon, P., Kiehn, T. E.: Large-scale clinical comparison of the lysis-centrifugation and radiometric systems for blood culture. Journal of Clinical Microbiology 1985, 22: 951–954.

    Google Scholar 

  23. Brannon, P., Kiehn, T. E.: Clinical comparison of lysis-centrifugation and radiometric resin systems for blood culture. Journal of Clinical Microbiology 1986, 24: 886–887.

    Google Scholar 

  24. Kiehn, T. E.: Five-years experience with the Isolator lysis-centrifugation blood culture system. Laboratory Medicine 1988, Supplement: 26–29.

  25. Witebsky, F. G., Keiser, J. F., Conville, P. S., Bryan, R., Park, C. H., Walker, R., Siddiqi, S. H.: Comparison of Bactec 13A medium and Du Pont Isolator for detection of mycobacteremia. Journal of Clinical Microbiology 1988, 26: 1501–1505.

    Google Scholar 

  26. Kiehn, T. E., Cammarata, R.: Comparative recoveries ofMycobacterium avium-Mycobacterium intracellulare from Isolator lysis-centrifugation and Bactec 13A blood culture systems. Journal of Clinical Microbiology 1988, 26: 760–761.

    Google Scholar 

  27. Kiehn, T. E., Edwards, F. F.: Rapid identification using a specific DNA probe ofMycobacterium avium complex from patients with acquired immunodeficiency syndrome. Journal of Clinical Microbiology 1987, 25: 1551–1552.

    Google Scholar 

  28. Kiehn, T. E.: Quantitative blood cultures: a review of 52 years. In: Brown, A. E., Armstrong, D. (ed.). Infectious complications of neoplastic disease. Yorke Medical Books, New York, 1985, p. 87–103.

    Google Scholar 

  29. Press, O. W., Ramsey, P. G., Larson, E. B., Fefer, A., Hickman, R. O.: Hickman catheter infections in patients with malignancies. Medicine 1984, 63: 189–200.

    Google Scholar 

  30. Shapiro, E. D., Wald, E. R., Nelson, K. A., Spiegelman, K. N.: Broviac catheter-related bacteremia in oncology patients. American Journal of Diseases of Children 1982, 136: 679–681.

    Google Scholar 

  31. Whimbey, E., Kiehn, T. E., Brannon, P., Benezra, D., Armstrong, D.: Clinical significance of colony counts in immunocompromised patients withStaphylococcus aureus bacteremia. Journal of Infectious Diseases 1987, 155: 1328–1330.

    Google Scholar 

  32. Whimbey, E., Wong, B., Kiehn, T. E., Armstrong, D.: Clinical correlations of serial quantitative blood cultures determined by lysis-centrifugation in patients with persistent septicemia. Journal of Clinical Microbiology 1984, 19: 766–771.

    Google Scholar 

  33. Wing, E. J., Norden, C. W., Shadduck, R. K., Winkelstein, A.: Use of quantitative bacteriologic techniques to diagnose catheter-related sepsis. Archives of Internal Medicine 1979, 139: 482–483.

    Google Scholar 

  34. Raucher, H. S., Hyatt, A. C., Barzilai, A., Harris, M. B., Weiner, M. A., LeLeiko, N. S., Hodes, D. S.: Quantitative blood cultures in the evaluation of septicemia in children with Broviac catheters. Journal of Pediatrics 1984, 104: 29–33.

    Google Scholar 

  35. Mosca, R., Curtas, S., Forbes, B., Meguid, M. M.: The benefits of Isolator cultures in the management of suspected catheter sepsis. Surgery 1987, 102: 718–723.

    Google Scholar 

  36. Andremont, A., Paulet, R., Nitenberg, G., Hill, C.: Value of semiquantitative cultures of blood drawn through catheter hubs for estimating the risk of catheter tip colonization in cancer patients. Journal of Clinical Microbiology 1988, 26: 2297–2299.

    Google Scholar 

  37. Benezra, D., Kiehn, T. E., Gold, J. W. M., Brown, A. E., Turnbull, A. D. M., Armstrong, D.: Prospective study of infections in indwelling central venous catheters using quantitative blood cultures. American Journal of Medicine 1988, 85: 495–498.

    Google Scholar 

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  1. Diagnostic Microbiology Laboratory, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, 10021, New York, New York, USA

    T. E. Kiehn

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Kiehn, T.E. Bacteremia and fungemia in the immunocompromised patient. Eur. J. Clin. Microbiol. Infect. Dis. 8, 832–837 (1989). https://doi.org/10.1007/BF02185856

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