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Epidemiology and Prevention of Infection in the Compromised Host

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Clinical Approach to Infection in the Compromised Host

Abstract

A useful approach to the study of infection in the immunocompromised host is to first consider what factors make such a patient a compromised host. Knowledge regarding the major compromising factors then allows one to focus on diagnostic, therapeutic and preventative measures specific for that patient’s specific infection risks. These dysfunctions of host-defense mechanisms or factors that predispose to infection are discussed together with the types of infections with which they are most commonly associated.

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Reference

  1. Bodey GP, Buckley M, Sathe YS, et al: Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann Intern Med 64: 328–340, 1966.

    PubMed  CAS  Google Scholar 

  2. Schimpff SC, Hahn DM, Brouillet MD, et al: Infection prevention in acute leukemia: Comparison of basic infection prevention techniques, with standard room reverse isolation or with reverse isolation plus added air filtration. Leuk Res 2: 231–240, 1978.

    Google Scholar 

  3. Dale DC, Guerry D, Wewerka IV Jr, et al: Chronic neutropenia. Medicine (Baltimore) 58: 128–144, 1979.

    CAS  Google Scholar 

  4. Schimpff SC, Young VM, Greene WH, et al: Origin of infection in acute nonlymphocytic leukemia. Significance of hospital acquisition of potential pathogens. Ann Intern Med 77: 707–714, 1972.

    PubMed  CAS  Google Scholar 

  5. Overholser CD, Peterson DE, Williams LT, et al: Periodontal infections in patients with acute nonlymphocytic leukemia: Prevalence of acute exacerbations. Arch Intern Med 142: 551–554, 1982.

    PubMed  CAS  Google Scholar 

  6. Levine AS, Schimpff SC, Graw RG Jr, et al: Hematologic malignancies and other marrow failure states: Progress in the management of complicating infections. Semin Hematol 11: 141–202, 1974.

    PubMed  CAS  Google Scholar 

  7. Aisner, J, Murillo J, Schimpff SC, et al: Invasive aspergillosis in acute leukemia: Correlation with nose cultures and antibiotic use. Ann Intern Med 90: 4–9, 1979.

    PubMed  CAS  Google Scholar 

  8. Wade JC, Schimpff SC, Newman KA, et al: Staphylococcus epidermidis: An increasingly but frequently unrecognized cause of infection in granulocytopenic patients. Ann Intern Med 97:503–508, 1982.

    Google Scholar 

  9. Winston DW, Dudnick DV, Chapin M, et al: Coagulase-negative staphylococcal bacteremia in patients receiving immunosuppressive therapy. Arch Intern Med 143: 32–36, 1983.

    PubMed  CAS  Google Scholar 

  10. Young RC, Corder MP, Haynes HA, et al: Delayed hypersensitivity in Hodgkin’s disease. A study of 103 untreated patients. Am J Med 52: 63–72, 1972.

    PubMed  CAS  Google Scholar 

  11. Seligmann M, Chess L, Fahey JL, et al: AIDS-An immunologic reevaluation. N Engl J Med 311: 1286–1292, 1984.

    PubMed  CAS  Google Scholar 

  12. Fahey JL, Scoggins R, Utz JP, et al: Infection, antibody response and gamma blogulin components in multiple myeloma and macroglobulinemia. Am JMed 35:698707, 1963.

    Google Scholar 

  13. Winston DJ, Gale RP, Meyer DV, et al: Infectious complications of human bone marrow transplantation. Medicine (Baltimore) 58: 1–31, 1979.

    CAS  Google Scholar 

  14. Meyers JD, Flournoy N, Thomas ED: Non-bacterial pneumonia after allogeneic marrow transplantation: A review of ten year’s experience. Rev Infect Dis 4:I 119–1132, 1982.

    Google Scholar 

  15. Schimpff SC, Aisner J, Wiemik PH: Infection in acute nonlymphocytic leukaemia: The alimentary canal as a major source of pathogens. In van der Waaij D, Verhoef J (eds): New Criteria for Antimicrobial Therapy - Maintenance of Digestive Tract Colonization Resistance. Excerpta Medica, Amsterdam, 1979, pp. 12–29.

    Google Scholar 

  16. Schimpff SC, Moody MM, Young VM: Relationship of colonization with Pseudomonas aeruginosa to development of Pseudomonas bacteremia in cancer patients. Antimicrob Ag Chemother 10: 240–244, 1970.

    CAS  Google Scholar 

  17. Schimpff SC: Surveillance cultures. J Infect Dis 144: 81–84, 1981.

    PubMed  CAS  Google Scholar 

  18. Newman KA. Schimpff SC, Young VM, et al: Lessons learned from surveillance cultures from patients with acute nonlymphocytic leukemia: Usefulness for epidemiologic preventive and therapeutic research. AmJMed 70: 423–431, 1981.

    Google Scholar 

  19. Cohen ML, Murphy MT, Counts GW, et al: Prediction by surveillance cultures of bacteremia among neutropenic patients treated in a protective environment. J Infect Dis 147: 489–793, 1984.

    Google Scholar 

  20. Bodey GP: Epidemiological studies of Pseudomonas sepsis in patients with leukemia. Am J Med Sci 260: 82–89, 1970.

    PubMed  CAS  Google Scholar 

  21. Selden R, Lee S, Want WLL, et al: Nosocomial Klebsiella infections: Intestinal colonization as a reservoir. Ann Intern Med 74: 675–664, 1971.

    Google Scholar 

  22. van der Waaij D, Tielemans-Speltie TM, Roeck-Houben AJ: Infection by and distribution of biotypes of Enterobacteriaceae species in leukemic patients treated under ward conditions and in units for protective isolation in seven hospitals in Europe. Infection 3 :188–194, 1977.

    Google Scholar 

  23. Kramer BS, Pizzo PA, Robichaud KJ, et al: Role of serial microbiologic surveillance and clinical evaluation in the management of cancer patients with fever and granulocytopenia. Am J Med 72: 561–568, 1982.

    PubMed  CAS  Google Scholar 

  24. Aisner J, Schimpff SC, Sutherland JC, et al: Torulopsis glabrata infections in patients with cancer: Increasing incidence and relationship to colonization. Am J Med 61: 23–28, 1976.

    PubMed  CAS  Google Scholar 

  25. Johanson WG, Pierce AK, Sanford JP: Changing pharyngael bacterial flora of hospitalized patients. Emergence of gram-negative bacilli. N Engl J Med 281: 1137–1140, 1969.

    PubMed  CAS  Google Scholar 

  26. Schwartz SN, Dowling JN, Benkovic C, et al: Sources of gram-negative bacilli colonizing the tracheae of intubated patients, J Infec Dis 138: 227–231, 1978.

    CAS  Google Scholar 

  27. van der Waaij D: The colonization resistance of the digestive tract in man and animals. Presented at the Sixth International Symposium for Gnotobiology, Ulm, Germany, June 1978

    Google Scholar 

  28. Schimpff SC, Greene WH, Young VM, et al: Infection prevention in acute nonlymphocytic leukemia. Laminar air flow room reverse isolation with oral, nonabsorbable antibiotic prophylaxis. Ann Intern Med 82: 351–358, 1975.

    PubMed  CAS  Google Scholar 

  29. Hahn DM, Schimpff SC, Fortner CL, et al: Infection in acute leukemia patients receiving oral nonabsorbable antibiotics. Antimicrob Agents Chemother 13: 958–964, 1978.

    PubMed  CAS  Google Scholar 

  30. van der Waaij D, de Vries JM, Lekkerkerk JEC: Colonization resistance of the digestive tract in conventional and antibiotic-treated mice. J Hyg (Camb) 69: 405–411, 1971.

    Google Scholar 

  31. Schroth MN, Cho JJ, Green SK, et al: Epidemiology of Pseudomonas aeruginosa in agricultural areas. In Young VM (ed): Pseudomonas aeruginosa. Ecological Aspects and Patient Colonization. Raven, New York, 1977, pp. 1–29.

    Google Scholar 

  32. Springmeyer SC, Silvestri RC, Sale GE, et al: The role of transbronchial biopsy for the diagnosis of diffuse pneumonias in immunocompromised marrow transplant recipients. Am Rev Respir Dis 26: 763, 1982.

    Google Scholar 

  33. Taplin D, Mertz PM: Flower vases in hospitals as reservoirs of pathogens. Lancet 2: 1279–1281. 1973.

    PubMed  CAS  Google Scholar 

  34. McDonald GB, Sharma P, Sale G, et al: Infectious esophagitis in immunosuppressed patients after marrow transplantation. Gastroenterology 88: 1111–1117, 1985.

    PubMed  CAS  Google Scholar 

  35. Carson LA, Peterson NJ, Favero MS, et al: Growth characteristics of atypical mycobacteria in water and their comparative resistance to disinfectants. Appl Environ Microbiol 36: 839–846, 1978.

    PubMed  CAS  Google Scholar 

  36. Cross DF, Benchimol A, Diamond EG: The faucet aerator-A source of pseudomonas infection. N Engl J Med 274: 1430–1431, 1966.

    PubMed  CAS  Google Scholar 

  37. Knight V: Instruments and infection. Hosp Pract 2: 82–95, 1967.

    Google Scholar 

  38. Edmondson EG, Reinarz JA. Pierce AK, et al: Nebulization equipment. A potential source of infection in gram-negative pneumonias. Am J Dis Child 111:357–360, 1966.

    Google Scholar 

  39. Aisner J, Schimpff SC. Bennett JE, et al: Aspergillus infections in cancer patients: Association with fireproofing materials in a new hospital. JAMA 235:411–412, 1976.

    Google Scholar 

  40. Eickhoff TC: Epidemiology of Legionnaire’s disease. Ann Intern Med 90: 499–502, 1979.

    PubMed  CAS  Google Scholar 

  41. Kirby BD, Snyder KM, Meyer RD, et al: Legionnaire’s disease: Report of sixty-five nosocomially acquired cases and review of the literature. Medicine (Baltimore) 59: 188–205, 1980.

    CAS  Google Scholar 

  42. Fekety FR: The epidemiology and prevention of staphylococcal infection. Medicine (Baltimore) 43: 593–613, 1964.

    Google Scholar 

  43. Hurst V, Sutter VL: Survival of Pseudomonas aeruginosa in the hospital environment. Jlnfect Dis 116: 151–154, 1966.

    CAS  Google Scholar 

  44. Morse LJ, Schonbeck LE: Hand lotions-A potential nosocomial hazard. N Engl J Med 278: 364–369, 1968.

    Google Scholar 

  45. Mellow MH, Lewis RJ: Endoscopy related bacteremia. Arch Intern Med 136: 667–669, 1976.

    PubMed  CAS  Google Scholar 

  46. Greene WH, Moody M, Hartley R, et al: Esophagoscopy as a source of Pseudomonas aeruginosa sepsis in patients with acute leukemia: The need for sterilization of endoscopes. Gastroenterology 67: 912–919, 1974.

    PubMed  CAS  Google Scholar 

  47. Phillips I: Pseudomonas aeruginosa respiratory tract infections in patients receiving mechanical ventilation. J Hyg (Camb) 65: 229–235, 1967.

    CAS  Google Scholar 

  48. Holder IA: Epidemiology of Pseudomonas aeruginosa in a burns hospital. In Young VM (ed): Pseudomonas aeruginosa. Ecological Aspects and Patient Colonization. Raven, New York, 1977, pp. 86–89.

    Google Scholar 

  49. McDade JJ, Hall LB: Survival of gram-negative bacteria in the environment. I. Effect of relative humidity on surface exposed organisms. Am J Hyg 80: 192–204, 1964.

    PubMed  CAS  Google Scholar 

  50. Plotkin SA, Austrian R: Bacteremias caused by Pseudomonas sp. following the use of materials stored in solutions of a cationic surface active agent. Am J Med Sci 235:621–627, 1958. •

    Google Scholar 

  51. Malizia WF, Gangarosa EJ, Goley AF: Benzalkonium chloride as a source of infection. N Engl J Med 263: 800–802, 1960.

    PubMed  CAS  Google Scholar 

  52. Newman KA, Tenney JH, Oken HA, et al: Persistent isolation of an unusual Pseudomonas sp. from a phenolic disinfectant system for laminar air flow rooms. Infect Cont 5: 219–222, 1984.

    CAS  Google Scholar 

  53. Perry S, Penland WZ: The portable laminar flow isolator: New Unit for patient protection in a germ-free environment. In Mathe G (ed): Recent Results in Cancer Research. Springer-Verlag, New York, 1970, pp. 34–40.

    Google Scholar 

  54. Bodey GP, Johnson D: Microbiological evaluation of protected environments during patient occupancy. Appl Microbiol 22: 828–836, 1971.

    PubMed  CAS  Google Scholar 

  55. Dietrich M, Gaus W, Vossen J, et al: Protective isolation and antimicrobial decontamination in patients with high susceptibility to infection. A prospective cooperative study of gnotobiotic care in acute leukemia patients. I. Clinical results. Infection 5: 3–10, 1977.

    Google Scholar 

  56. Yates JW, Holland JF: A controlled study of isolation and endogenous microbial suppression in acute myelocytic leukemia patients. Cancer 32: 1490–1498, 1973.

    PubMed  CAS  Google Scholar 

  57. Levine AS, Siegel SE, Schreiber AD, et al: Protected environments and prophylactic antibiotis. A prospective controlled study of their utility in the therapy of acute leukemia. N Engl J Med 288: 477–483, 1973.

    PubMed  CAS  Google Scholar 

  58. Stoning RA, Jameson B, McElwain TJ, et al: Oral non-absorbable antibiotics prevent infection in acute non-lymphoblastic leukemia. Lancet 2: 837–840, 1977.

    Google Scholar 

  59. Dietrich M, Rasche H, Rommel K. et al: Antimicrobial therapy as part of the decontamination procedures for patients with acute leukemia. Eur J Cancer 9: 443–447, 1973.

    PubMed  CAS  Google Scholar 

  60. Cohen MH, Creaven PJ, Fosseick BE Jr, et al: Effect of oral prophylactic broad spectrum nonabsorbable antibiotics on the gastrointestinal absorption of nutrients and methotrexate in small cell bronchogenic carcinoma patients. Cancer 38: 1556–1559, 1976.

    PubMed  CAS  Google Scholar 

  61. Klastersky J, Debusscher L, Weerts D, et al: Use of oral antibiotics in protected units environment: Clinical effectiveness and role in the emergence of antibiotic-resistant strains. Pathol Biol 22: 5–12, 1973.

    Google Scholar 

  62. Buckner CD, Clift RA, Sanders JE, et al: Protective environment for marrow transplant recipients. A prospective study. Ann Intern Med 89: 893–901, 1978.

    PubMed  CAS  Google Scholar 

  63. Bodey GP, Gehan EA, Frereich J, et al: Protected environment-prophylactic antibiotic program in the chemotherapy of acute leukemia. Am J Med Sci 262: 138–151, 1971.

    PubMed  CAS  Google Scholar 

  64. Schimpff SC: Infection prevention during granulocytopenia. In Remington JS, Schwartz MN (eds): Current Clinical Topics in Infectious Diseases. McGraw-Hill, New York, 1980, pp. 85–106.

    Google Scholar 

  65. Pizzo PA, Levine AS: The utility of protected-environment regimens for the compromised host: A critical assessment. In Brown EB (ed): Progress in Hematology. Grune & Stratton, New York, 1977, pp. 311–332.

    Google Scholar 

  66. Holland J, Plumb M, Yates J, et al: Psychological response of patients with acute leukemia to germ-free environments. Cancer 40: 871–879, 1977.

    PubMed  CAS  Google Scholar 

  67. Buckner CD, Clift RA, Thomas ED, et al: Prophylaxis of infections in patients with acute leukemia receiving allogeneic marrow transplants. Infection 11: 243–250, 1983.

    PubMed  CAS  Google Scholar 

  68. Navari, RM, Buckner CD, Clift RA, et al: Prophylaxis of infection in patients with aplastic anemia receiving allogeneic marrow transplants. Am J Med 76: 564–572, 1984.

    PubMed  CAS  Google Scholar 

  69. Schiffer CA, Aisner J, Daly PA, et al: Alloimmunization following prophylactic granulocyte transfusions. Blood 54: 766–774, 1979.

    PubMed  CAS  Google Scholar 

  70. Clift RA, Sanders JE, Thomas ED, et al: Granulocyte transfusions for the prevention of infection in patients receiving bone marrow transplantation. N Engl J Med 298: 1052–1057, 1978.

    PubMed  CAS  Google Scholar 

  71. Mannoni P, Martine R, Radeau E, et al: Granulocyte transfusion: Efficiency of prophylactic granulocyte transfusions in care of patients with acute leukemia. In Hogman CS, Lin-dahl-Kiessling K, Wigzell H (eds): BloodLeucocytes: Function and Use in Therapy. Almquist and Wiksell, Stockholm, 1977, pp. 72–80.

    Google Scholar 

  72. Ford JM, Cullen MH: Prophylactic granulocyte transfusions. Exp Hematol (Suppl) 5: 65–72, 1977.

    Google Scholar 

  73. Cooper MR, Heise E. Richards F, et al: A prospective study of histocompatible leucocyte and platelet transfusion during chemotherapeutic induction of acute myeloblastic leukemia. In Goldman JM, Lowenstein RM (eds): Leukocytes: Separation, Collection and Transfusion. Academic, New York, 1975, pp. 436–449.

    Google Scholar 

  74. Winston DJ, Winston GH, Howell CL, et al: Cytomegalovirus infections associated with leukocyte transfusions. Ann Intern Med 93: 671–675, 1980.

    PubMed  CAS  Google Scholar 

  75. Hersman J, Meyers JD, Thomas ED, et al: The effect of granulocyte transfusions on the incidence of cytomegalovirus infection after allogeneic marrow transplantation. Ann Intern Med 96: 149–15, 1982.

    PubMed  CAS  Google Scholar 

  76. Nausef WM, Maki DG: A study of the value of simple protective isolation in patients with granulocytopenia. N Engl J Med 304: 448–453, 1981.

    Google Scholar 

  77. Wade JC, McGaffey M, Wiemik, PH, et al: Hepatitis among patients with acute nonlymphocytic leukemia. Am J Med 75: 413–422, 1983.

    PubMed  CAS  Google Scholar 

  78. Favero MS, Maynard JE, Peterson NJ, et al: Hepatitis B antigen on environmental surfaces. Lancet 2: 1455. 1973.

    PubMed  CAS  Google Scholar 

  79. Centers for Disease Control: Hepatitis. Control Measure for Hepatitis B in Dialysis Centers HEW Publication No. (CDC) 78:8358, Atlanta, Georgia 30333, 1978.

    Google Scholar 

  80. Hargadon MT, Young VM, Schimpff SC, et al: Selective suppression of alimentary tract microbial flora as prophylaxis during granulocytopenia. Antimicrob Agents Chemother 20: 620–624, 1981.

    PubMed  CAS  Google Scholar 

  81. Wade JC, Joshi J, Devlin A, Moody MC: Alterations in stool anaerobes following antimicrobial therapy. Abst. 955. In Twenty-fifth Interscience Conference on Antimicrobial Agents and Chemotherapy and Infectious Diseases Society of America, Minneapolis, Minnesota, September 1985

    Google Scholar 

  82. Rozenberg-Arska M, Dekker AW, Verhoef J: Ciprofloxacin for selective decontamination of the alimentary tract in patients with acute leukemia during remission induction treatment: The effect on fecal flora. J Infect Dis 152: 104–107, 1985.

    PubMed  CAS  Google Scholar 

  83. Knothe H: The effect of a combined preparation of trimethoprim-sulfamethoxazole following short-term and long-term administration on the flora of the human gut. Chemotherapy 18: 285–296, 1973.

    PubMed  CAS  Google Scholar 

  84. Hughes WT, Kuhn S, Chaudhary S, et al: Successful chemoprophylaxis for Pneumocystis carinii pneumonitis. N Engl J Med 297: 1419–1426, 1977.

    PubMed  CAS  Google Scholar 

  85. Gurwith MJ, Brunton JL, Lank BA, et al: A prospective controlled investigation of prophylactic trimethoprim-sulfamethoxazole in hospitalized granulocytopenic patients. Am J Med 66: 248–254, 1979.

    PubMed  CAS  Google Scholar 

  86. Gualtieri RJ, Donowitz GR, Kaiser DL, et al: Double-blind randomized study of prophylactic trimethoprim-sulfamethoxazole in granulocytopenic patients with hematologic malignancies. Am J Med 74: 934–940, 1983.

    PubMed  CAS  Google Scholar 

  87. Kauffman CA, Liepman MK, Bergman AG, et al: Tri-methoprim-sulfamethoxazole prophylaxis in neutropenic patients. Am J Med 74: 599–608, 1983.

    PubMed  CAS  Google Scholar 

  88. Zinner SH, Schimpff SC, Klastersky J, et al: Trimethoprimsulfamethoxazole in the prevention of infection in neutropenic patients. Abstr. 795. In Twenty-first Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, 1981

    Google Scholar 

  89. Sleijfer DTH, Mulder NH, de Vries-Hospers, et al: Infection prevention in granulocytopenic patients by selective decontamination of the digestive tract. EurJ Cancer 16: 859–869, 1980.

    CAS  Google Scholar 

  90. Dekker AW, Rozenberg-Arska M, Sixma JJ, et al: Prevention of infection by trimethoprim-sulfamethoxazole plus amphotericin-B in patients with acute nonlymphocytic leukaemia. Ann Intern Med 95: 555–559, 1981.

    PubMed  CAS  Google Scholar 

  91. Estey E, Maksymiuk A, Smith T, et al: Infection prophylaxis in acute leukemia: Comparative effectiveness of sulfamethoxazole and trimethoprim, ketoconazole, and a combination of the two. Arch Intern Med 144: 1562–1568, 1984.

    PubMed  CAS  Google Scholar 

  92. Weiser B, Lange M, Fialk MA, et al: Prophylactic trimethoprim-sulfamethoxazole during consolidation chemotherapy for acute leukemia: A controlled trial. Ann Intern Med 95: 436–438, 1981.

    PubMed  CAS  Google Scholar 

  93. de Jongh CA, Wade JC, Finley RS, et al: Trimethoprimsulfamethoxazole versus placebo: A double-blind comparison of infection prophylaxis in patients with small cell carcinoma of the lung. J Clin Oncol 1: 302–307, 1983.

    PubMed  Google Scholar 

  94. Riben PD, Louie TJ, Lank BA, et al: Reduction in mortality from gram-negative sepsis in neutropenic patients receiving trimethoprim-sulfamethoxazole therapy. Cancer 51: 1587–1592, 1983.

    PubMed  CAS  Google Scholar 

  95. Watson JG, Powles RL, Lawson, et al: Co-trimexazole versus non-absorbable antibiotics in acute leukaemia. Lancet 1: 6–9. 1982.

    PubMed  CAS  Google Scholar 

  96. Wade JC, Schimpff SC, Hargadon MT, et al: A comparison of trimethoprim-sulfamethoxazole plus nystatin with gentamicin plus nystatin in the prevention of infections in acute leukemia. N Engl J Med 304: 1057–1061, 1981.

    PubMed  CAS  Google Scholar 

  97. Wade JC, de Jongh CA, Newman KA, et al: Selective antimicrobial modulation as prophylaxis against infection during granulocytopenia: Trimethoprim-sulfamethoxazole vs. naladixic acid. J Infect Dis 147: 624–634, 1983.

    PubMed  CAS  Google Scholar 

  98. Bow EJ, Louis TJ, Riben PD, et al: Randomized controlled trial comparing trimethoprim-sulfamethoxazole and trimethoprim for infection prophylaxis in hospitalized granulocytopenic patients. Am J Med 76: 223–233, 1984.

    PubMed  CAS  Google Scholar 

  99. Enno A, Darrell J, Hows J, et al: Co-trimoxazole for prevention of infection in acute leukaemia. Lancet 1: 395–397, 1978.

    Google Scholar 

  100. Starke ID, Catowsky D, Johnson SA, et al: Co-trimaxazole alone for prevention of bacterial infection in patients with acute leukaemia. Lancet 1: 5–6, 1982.

    PubMed  CAS  Google Scholar 

  101. Pizzo PA, Robichaud KJ, Edwards BK, et al: Oral antibiotic prophylaxis in patients with cancer: A double-blind randomized placebo-controlled trial. J Pediatr 102: 125–133, 1983.

    PubMed  CAS  Google Scholar 

  102. Kramer BS, Carr DJ, Rand KH, et al: Prophylaxis of fever and infection in adult cancer patients. A placebo-controlled trial of oral trimethoprim-sulfamethoxazole plus erythromycin. Cancer 53: 329–335, 1984.

    PubMed  CAS  Google Scholar 

  103. Karp JE, Hendricksen C, Redden T et al: Double-blind randomized trial of oral prophylactic norfloxacin on infection in acute leukemia. Abst. 149. In Twenty-fifth Inter-science Conference on Antimicrobial Agents and Chemotherapy, Minneapolis, Minnesota, 1985

    Google Scholar 

  104. Winston DJ, Ho WG, Nakao SI, et al: Norfloxacin versus vancomycin/polymixin for prevention of infections in granulocytopenic patients. Abst. 386. In Twenty-fourth Inter-science Conference on Antimicrobial Agents and Chemotherapy, Washington, DC, 1984

    Google Scholar 

  105. Joshi JH, Finley RS, Tenney, JH, et al: A comparison of the efficacy and safety of norfloxacin plus amphotericin-B and cotrimaxazole plus amphotericin-B for infection prophylaxis in patients with granulocytopenia. SS 4.6/9, 38/46–38/50. In Thirteenth International Congress of Chemotherapy, Vienna, Austria, 1983

    Google Scholar 

  106. Bow EJ, Louie TJ, Rayner E, et al: Norfloxacin (N) versus trimethoprim-sulfamethoxazole (T/S) for infection prevention in patients (pts) with acute leukemia (AL). Abs. 150. In Twenty fifth Interscience Conference on Antimicrobial Agents and Chemotherapy, Minneapolis, Minnesota, 1985

    Google Scholar 

  107. Roenberg-Arska M, Dekker AW, Verhoef J: A comparison of ciprofloxacin (CF) to trimethoprim/sulfamethoxazole plus colistin (T/S+C) for infection prevention in patients (pts) with acute leukemia during remission induction treatment. Abst. 151. In Twenty-fifth Interscience Conference on Antimicrobial Agents and Chemotherapy, Minneapolis, Minnesota, 1985

    Google Scholar 

  108. Wilson JM, Guiney DG: Failure of oral trimethoprim-sulfamethoxazole prophylaxis in acute leukemia. Isolation of resistant plasmids from stains of Enterobactericeae causing bacteremia. N Engl J Med 306: 16–20, 1982.

    PubMed  CAS  Google Scholar 

  109. Jacoby GA: Perils of prophylaxis. N Engl J Med 306: 43–44, 1982.

    PubMed  CAS  Google Scholar 

  110. Fainsein V, Rodriguez V, Turck M, et al: Patterns of oropharyngeal and fecal flora in patients with acute leukemia. J Infect Dis 144: 10–18, 1981.

    Google Scholar 

  111. Kostiala I, Kostiala AAI, Kahanpaa A: Acute fungal stoma-titis in patients with hematologic malignancies: Quantity and species of fungi. J Infect Dis 202: 1476–1479, 1982.

    Google Scholar 

  112. Sandford GR, Merz W, Wingard JR, et al: The value of fungal surveillance cultures as predictors of systemic fungal infections. J Infect Dis 142: 503–509, 1980.

    PubMed  CAS  Google Scholar 

  113. Stone HH, Geheber CE, Kolk LD, et al: Alimentary tract colonization by Candida albicans. J Surg Res 14: 273–276, 1973.

    CAS  Google Scholar 

  114. Wingard JR, Merz WG, Saral R: Candida tropicalis: A major pathogen in immunocompromised patients. Ann Intern Med 91: 539–543, 1979.

    PubMed  CAS  Google Scholar 

  115. Witten VH, Katz SI: Nystatin. Med Clin North Am 54: 1329–1337. 1970.

    PubMed  CAS  Google Scholar 

  116. Carpenteri U, Haggard ME, Lockhart LH, et al: Clinical experience in prevention of candidiasis by nystatin in children with acute lymphocytic leukemia. J Pediatr 92: 593595, 1978.

    Google Scholar 

  117. Pizzuto J, Conte G, Aviles A, et al: Centro Medico National Hospital General: Nystatin prophylaxis in leukemia and lymphoma. N Engl J Med 299: 661–662, 1978.

    PubMed  CAS  Google Scholar 

  118. DeGregoria MW, Lee WMF, Ries CA: Candida infections in patients with acute leukemia: Ineffectiveness of nystatin prophylaxis and relationship between oropharyngeal and systemic candidiasis. Cancer 50: 2780–2784, 1982.

    Google Scholar 

  119. Williams C, Whitehous JMA, Lister TA, et al: Oral anticandidal prophylaxis in patients undergoing chemotherapy for acute leukemia. Med Pediatr Oncol 3: 275–280, 1977.

    PubMed  CAS  Google Scholar 

  120. Sleijfer DT, Mulder NH, de Vries-Hospers HG, et al: Infection prevention in granulocytopenic patients by selective decontamination of the digestive tract. Eur J Cancer 16: 859869, 1980.

    Google Scholar 

  121. Ezdinli EZ, O’Sullivan DD, Wasser LP, et al: Oral amphotericin for candidiasis in patients with hematologic neoplasms: An autopsy study. JAMA 24: 258–260, 1979.

    Google Scholar 

  122. Owens NJ, Nightingale CH, Schweizer RT, et al: Prophylaxis of oral candidiasis with clortimazole troches. Arch Intern Med 144: 290–193, 1984.

    PubMed  CAS  Google Scholar 

  123. Brincker H: Prophylactic treatment with miconazole in patients highly predisposed to fungal infection. Acta Med Scand 204: 123–128, 1978.

    PubMed  CAS  Google Scholar 

  124. Acuna G, Winston DJ, Young LS: Ketoconazole prophylaxis of fungal infections in the granulocytopenic patient: A double-blind, randomized controlled trial. Abst. 852. In Twenty-first Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, Illinois, November 1981

    Google Scholar 

  125. Brincker H: Prevention of mycosis in granulocytopenic leukemia patients with prophylactic ketoconazole treatment. Abst. 850. In Twenty-first Interscience Conference on Antimicrobial Agents and Chemotherapy; Chicago, Illinois, November 1981

    Google Scholar 

  126. Maksymiuk AW, Estey W, Keating MJ, et al: Infection prophylaxis during remission induction therapy of acute leukemia. Abst. C327. In Seventeenth Annual Meeting of the American Society of Clinical Oncology, Washington, DC, April 1981

    Google Scholar 

  127. Siegel M, Murphy M, Counts GW, et al: Prophylactic ketoconazole for the prevention of fungal infection in bone marrow transplant patients. Abst. 166. In Twenty-second Interscience Conference on Antimicrobial Agents and Chemotherapy, Miami, Florida, October 1982

    Google Scholar 

  128. Hann IM, Corringham, R, Keaney M, et al: Ketoconazole versus nystatin plus amphotericin-B for fungal prophylaxis in severely immunocompromised patients. Lancet 1: 826829, 1982.

    Google Scholar 

  129. Meunier-Carpentier F, Snoeck R, Klastersky J: Oral anti-fungal prophylaxis in neutropenic cancer patients (pts). Abstract 10. In Program and Abstracts of the Twenty-second Interscience Conference on Antimicrobial Agents and Chemotherapy, Miami, Florida, October 1982

    Google Scholar 

  130. de Jongh C, Finley R, Joshi, et al: A comparison of ketoconazole to nysatin: Prophylaxis of fungal infection in neutropenic patients. Abstract 497. In Program and Abstracts of the Twenty-second Interscience Conference on Antimicrobial Agents and Chemotherapy, Miami, Florida, October 1982

    Google Scholar 

  131. Vaughan WP, Saral R, Wingard JR, et al: Miconazole (M) prophylaxis against fungal sepsis (FS) complicating empiric antibiotics during chemotherapy induced aplasia. Abstract C726. In Eighteenth Annual Meeting of the American Society of Clinical Oncology, St. Louis, Missouri, April 1982

    Google Scholar 

  132. Fainstein V, Elting L, Bodey GP: Treatment for antibiotic resistant fever with trimethoprim-sulfamethoxazole ± miconazole in cancer patients. Abstract 797. In Program and Abstracts of the Twenty-first Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, Illinois, November 1981

    Google Scholar 

  133. Pizzo PA, Robichaud KJ, Gill FA, et al: Empiric antibiotic and antifungal therapy for cancer patients with prolonged fever and granulocytopenia. Am J Med 72: 101–1H, 1987.

    Google Scholar 

  134. Murillo J, Schimpff SC, Broullet MD: Axillary lesions in patients with acute leukemia. Evaluation of a preventive program. Cancer 43: 1493–1496, 1979.

    PubMed  CAS  Google Scholar 

  135. Sande MA, Mandell GL: Effect of rifampin on nasal carriage of Staphylococcus aureus. Antimicrob Agents Chemother 7: 294–297, 1975.

    CAS  Google Scholar 

  136. Finley RC, Schimpff SC, Fortner CL, et al.: Rifampin and cloxacillin in the reduction of Staphylococcus aureus colonization. Clin Pharm 1: 370–372, 1982.

    PubMed  CAS  Google Scholar 

  137. Hughes WT, Feldman S, Aur RJA, et al: Intensity of immunosuppressive therapy and the incidence of Pneumocystis carinii pneumonitis. Cancer 36: 2004–2009, 1975.

    PubMed  CAS  Google Scholar 

  138. Winston DJ, Williams KL, Gale RP and Young LW: Trimethoprim-sulfamethoxazole for the treatment of Pneumocystic carinii pneumonia. Ann Intern Med 92: 762–769, 1980.

    PubMed  CAS  Google Scholar 

  139. Meyers JD, Pifer LL, Sale GE, et al: The value of Pneumocystis carinii antibody and antigen detection for diagnosis of Pneumocystic carinii pneumonia after marrow transplantation. Am Rev Respir Dis 120: 1283–1287, 1979.

    PubMed  CAS  Google Scholar 

  140. Fischl MA, Dickinson GM: Trimethoprim-sulfamethoxazole prophylaxis of Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. Abstract 436. In Twenty-fifth Interscience Conference on Antimicrobial Agents and Chemotherapy, Miami, Florida, October 1982

    Google Scholar 

  141. Kovacs JA, Hiemenz JW, Macher AM, et al: Pneumocystis carinii pneumonia: A comparison between patients with the acquired immunodeficiency syndrome and patients with other immunodeficiencies. Ann Intern Med 100: 663–671, 1984.

    PubMed  CAS  Google Scholar 

  142. Schimpff SC, Serpick A, Block J, et al: Varicella zoster infection in patients with cancer. Ann Intern Med 76: 241–254, 1972.

    PubMed  CAS  Google Scholar 

  143. Schimpff SC, O’Connell MJ, Greene WH, et al: Infections in 92 splenectomized patients with Hodgkin’s disease: A clinical review. Am J Med 59: 695–701, 1975.

    PubMed  CAS  Google Scholar 

  144. Ruckdeschel JC, Schimpff SC, Smyth AC, et al: Herpes zoster and impaired cell-associated immunity to the varicella-zoster virus in patients with Hodgkin’s disease. Am J Med 62: 77–85, 1977.

    PubMed  CAS  Google Scholar 

  145. Atkinson K, Meyers JD, Storb R, et al: Varicella-zoster virus infection after marrow transplantation for aplastic anemia or leukemia. Transplantation 29: 47, 1980.

    PubMed  CAS  Google Scholar 

  146. Clift RA, Buckner CD, Fefer A, et al: Infectious complica Lions of marrow transplantation. Transplant Proc 6: 389–393, 1974.

    PubMed  CAS  Google Scholar 

  147. Winston DJ, Gale RO, Meyer DW, et al: Infectious complications of human bone marrow transplantation. Medicine (Baltimore) 58: 1–31, 1979.

    CAS  Google Scholar 

  148. Asano Y, Nakayama H, Yazaki T, et al: Protective efficacy of vaccination in children in four episodes of natural varicella and zoster in the ward. Pediatrics 59: 8–12, 1977.

    PubMed  CAS  Google Scholar 

  149. Asano Y, Nakayama H, Yazaki T, et al: Protection against varicella in family contacts by immediate inoculation with live varicella vaccine. Pediatrics 59: 3–7, 1977.

    PubMed  CAS  Google Scholar 

  150. Asano Y, Takahashi M: Clinical and serologic testing of a live varicella vaccine and two-year follow-up for immunity of the vaccinated children. Pediatrics 60: 810–814, 1977.

    PubMed  CAS  Google Scholar 

  151. Asano Y, Yazaki T, Miyata T, et al: Application of a live attenuated varicella vaccine to hospitalized children and its protective effect on spread of varicella infection. Biken J 18: 35–40, 1975.

    PubMed  CAS  Google Scholar 

  152. Brunel] PA, Geiser C, Sheheb Z, Waugh JE: Administration of live varicella vaccine to children with leukaemia. Lancet 2: 1019, 1982.

    Google Scholar 

  153. Izawa T, Ihara T, Hattori A, et al: Application of a live varicella vaccine in children with acute leukemia or other malignant diseases. Pediatrics 60: 805–809, 1977.

    PubMed  CAS  Google Scholar 

  154. Takahishi M, Otsuka T, Ojuno Y, et al: Live vaccine used to prevent the spread of varicella in children in hospital. Lancet 2: 1288, 1974.

    Google Scholar 

  155. Brunell PA, Gershon AA: Passive immunization against varicella-zoster infections and other modes of therapy. J Infect Dis 127: 415–423, 1973.

    PubMed  CAS  Google Scholar 

  156. Brunell PA, Ross A, Miller LH, Juo B: Prevention of varicella by zoster immunoglobulin. N Engl Med 280: 1191–1194, 1969.

    CAS  Google Scholar 

  157. Geiser CF, Bishop Y, Myers M, et al: Prophylaxis of varicella in children with neoplastic disease: Comparative results with zoster immune plasma and gammaglobulin. Cancer 35: 1027–1030, 1975.

    PubMed  CAS  Google Scholar 

  158. Gershon AA, Steinberg S, Brunch PA: Zoster immune globulin. A further assessment. N Engl JMed 290: 243–245, 1974.

    CAS  Google Scholar 

  159. Orenstein WA, Heymann DLL, Ellis RJ, et al: Prophylaxis of varicella in high-risk children: Dose-response effect of zoster immune globulin. J Pediatr 98: 368–373, 1981.

    PubMed  CAS  Google Scholar 

  160. Ross AH, Klein SW, McKennett B, et al: Zoster immune globulin. NY State J Med 74: 1367–1372, 1974.

    CAS  Google Scholar 

  161. Zaia JA, Levin MJ, Preblud SR, et al: Evaluation of varicella-zoster immune globulin: Protection of immunosuppressed children after household exposure to varicella. J Infect Dis 147: 737–743, 1983.

    PubMed  CAS  Google Scholar 

  162. Anonymous: Varicella-zoster immune globulin-United States. MMWR 30: 15–16, 21, 1981.

    Google Scholar 

  163. Meyers JD, Fluomoy N, Thomas ED: Infection with herpes simplex virus and cell mediated immunity after marrow transplant. J Infect Dis 142: 338–346, 1980.

    PubMed  CAS  Google Scholar 

  164. Saral R, Ambinder RF, Burns WH, et al: Acyclovir prophylaxis against recrudescent herpes simplex virus infections in leukemia patients: A randomized, double-blind placebo controlled study. Ann Intern Med 96: 11–14, 1982.

    Google Scholar 

  165. Lam MT, Pazin GJ, Armstrong JA, et al: Herpes simplex infection in acute myelogenous leukemia and other hematologic malignancies: A prospective study. Cancer 48: 2168–2171, 1981.

    PubMed  CAS  Google Scholar 

  166. Reeves WC, Corey L, Adams HG, et al: Risk of recurrence after first episodes of genital herpes. Relation to HSV type and antibody response. N Engl J Med 305: 315–319, 1981.

    PubMed  CAS  Google Scholar 

  167. Muller SA, Herrman EC Jr, Winkelmann RK: Herpes simplex infections in hematologic malignancies. Am J Med 52: 102–114, 1972.

    PubMed  CAS  Google Scholar 

  168. Meyers JD, Wade JC, Mitchell CD, et al: Multicenter collaborative trial of intravenous acyclovir for the treatment of mucocutaneous herpes simplex virus infection in the immunocompromised host. Am J Med 73A: 229–235, 1982.

    PubMed  CAS  Google Scholar 

  169. Mitchell CD, Gentry SR, Boen JR, et al: Acyclovir therapy for mucocutaneous herpes simplex infections in immunocompromised patients. Lancet 2: 1389–1392, 1981.

    Google Scholar 

  170. Wade, JC, Newton B, McLaren C, et al: Treatment of mucocutaneous herpes simplex virus infection after marrow transplantation with intravenous acyclovir: A double-blind trial. Ann Intern Med 96: 265–269, 1982.

    PubMed  CAS  Google Scholar 

  171. Hann IM, Prentice HG, Blacklock HA, et al: Acyclovir prophylaxis against herpes-virus infections in severely immunocompromised patients: randomized double blind trial. Br Med J 287: 384, 1983.

    CAS  Google Scholar 

  172. Saral R, Bums WH, Laskin OL, et al: Acyclovir prophylaxis of herpes-simplex-virus infections: A randomized, double-blind, controlled trial in bone-marrow-transplant recipients. N Engl J Med 305: 63–67, 1981.

    PubMed  CAS  Google Scholar 

  173. Bryson YJ, Dillon M, Lovett M, et al: Treatment of first episodes of genital herpes simplex virus infection with oralacyclovir: A randomized double-blind controlled trial in normal subjects. N Engl J Med 308: 916–921, 1983.

    PubMed  CAS  Google Scholar 

  174. Nilsen AE, Aasen T, Halsos AM, et al: Efficacy of oral acyclovir in the treatment of initial and recurrent genital herpes. Lancet 2: 571, 1982.

    PubMed  CAS  Google Scholar 

  175. Douglas JM, Critchlow C, Benedetti J, et al: A double-blind study of oral acyclovir for suppression of recurrences of genital herpes simplex virus infection. N Engl J Med 310: 1551–1556, 1984.

    PubMed  CAS  Google Scholar 

  176. Strauss SE, Takiff HE, Seidlin M, et al: Suppression of frequently recurring genital herpes: A placebo-controlled double-blind trial of oral acyclovir. N Engl J Med 310:15451550,1984.

    Google Scholar 

  177. Wade JC, Newton B, Flournoy N, et al: Oral acyclovir prophylaxis of herpes simplex virus infection after marrow transplant. Ann Intern Med 100: 823–828, 1984.

    PubMed  CAS  Google Scholar 

  178. Gluckman E, Devergie A, Melo R, et al: Prophylaxis of herpes infections after bone marrow transplantation by oral acyclovir. Lancet 2: 706, 1983.

    PubMed  CAS  Google Scholar 

  179. Bisno AL: Hyposplenism and overwhelming pneumococcal infection: A reappraisal. Am./ Med Sci 262: 101–107, 1971.

    CAS  Google Scholar 

  180. Desser RK, Ultmann JE: Risk of severe infection in patients with Hodgkin’s disease or lymphoma after diagnostic laparotomy and splenectomy. Ann Intern Med 77: 143–146, 1972.

    PubMed  CAS  Google Scholar 

  181. Siber GR, Weitzman SA, Aisenberg AC, et al: Impaired antibody response to pneumococcal vaccine after treatment for Hodgkin’s disease. N Engl J Med 299: 442–448, 1978.

    PubMed  CAS  Google Scholar 

  182. Lowenbraun S, Young V, Kenton D, Serpick A: Infection from intravenous “scalp-vein” needles in a susceptible population. JAMA 212: 45–453, 1970.

    Google Scholar 

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Wade, J.C., Schimpff, S.C. (1988). Epidemiology and Prevention of Infection in the Compromised Host. In: Rubin, R.H., Young, L.S. (eds) Clinical Approach to Infection in the Compromised Host. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-6645-8_2

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