Skip to main content
Log in

Value of surveillance cultures in the management of neutropenic patients

  • Article
  • Published:
European Journal of Clinical Microbiology and Infectious Diseases Aims and scope Submit manuscript

Abstract

To assess whether bacteriological surveillance cultures can be used to predict infection in neutropenic patients, cultures were performed during the period of neutropenia of nose, throat and urine specimens collected once weekly and faeces specimens collected twice weekly. Seventy-six consecutively observed patients undergoing chemotherapy for haematological or non-haematological diseases were investigated. Severe infection including septicaemia, lower respiratory tract infection, anorectal lesion and urinary tract infection occurred in 32 patients.Enterobacter cloacae, Escherichia coli andPseudomonas aeruginosa were the organisms most commonly involved. In the majority of cases of septicaemia the organisms were isolated from the faeces, often in pure culture, prior to the onset of septicaemia. Most of the isolates ofEnterobacter cloacae were resistant to the empiric antibiotic therapy used in the unit and were able to colonise multiple sites, presumably increasing the risk of subsequent infection. Faecal culture is the most useful approach in bacteriological surveillance in neutropenic patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bodey, G. P., Buckley, M., Sathe, Y. S., Freireich, E. J. Quantitative relationship between circulating leukocytes and infection in patients with acute leukemia. Annals of Internal Medicine 1966, 64: 328–340.

    PubMed  Google Scholar 

  2. Marcus, E. G., Goldman, J. M. Management of infection in neutropenic patient. British Medical Journal 1986, 293: 406–408.

    PubMed  Google Scholar 

  3. Buckner, C. D., Clift, R. A., Sanders, J. E., Meyer, J. D., Counts, G. W., Farewell, V. T., Thomas, E. D. andthe Seattle Marrow Transplant Team Protective environment for marrow transplant recipients — a prospective study. Annals of Internal Medicine 1978, 89: 893–901.

    PubMed  Google Scholar 

  4. De Vries-Hosper, H. G., Sleijfer, D. T., Mulder, N. H., van der Waaj, D., Nieweg, H. O., van Saene, H. K. F. Bacteriological aspects of selective decontamination of the digestive tract as a method of infection prevention in granulocytopenic patients. Antimicrobial Agents and Chemotherapy 1981, 19: 813–820.

    PubMed  Google Scholar 

  5. Cohen, M. I., Murphy, M. T., Counts, G. W., Buckner, C. D., Clift, R. A., Meyers, J. D. Prediction by surveillance cultures of bacteremia among neutropenic patients treated in a protective environment. Journal of Infectious Diseases 1983, 147: 789–793.

    PubMed  Google Scholar 

  6. Schimpff, S. C. Surveillance cultures. Journal of Infectious Diseases 1981, 144: 81–84.

    PubMed  Google Scholar 

  7. Galen, R. S., Gambino, S. R. Beyond normality: the predictive value and efficiency of medical diagnosis. John Wiley, New York, 1975, p. 29–40.

    Google Scholar 

  8. Stokes, E. J., Ridgway, G. L. Clinical bacteriology. Edward Arnold, London, 1980, p. 219–220.

    Google Scholar 

  9. Pitt, T. L. State of the art: typingPseudomonas aeruginosa. Journal of Hospital Infection 1980, 1: 193–199.

    Article  PubMed  Google Scholar 

  10. Gaston, M. A., Bucher, C., Pitt, T. L. O serotyping scheme forEnterobacter cloacae. Journal of Clinical Microbiology 1983, 18: 1079–1083.

    PubMed  Google Scholar 

  11. Gaston, M. A. Isolation and selection of bacteriophage typing set ofEnterobacter cloacae. Journal of Medical Microbiology 1987, 24: 285–290.

    PubMed  Google Scholar 

  12. Schimpff, S. C., Young, V. M., Greene, W. H., Vermeulen, G. D., Moody, M. R., Wiernik, P. H. Origin of infection in acute non-lymphocytic leukemia. Significance of hospital acquisition of potential pathogens. Annals of Internal Medicine 1972, 77: 707–714.

    PubMed  Google Scholar 

  13. Newman, K. A., Schimpff, S. C., Young, V. M., Wiernik, P. H. Lessons learned from surveillance cultures in patients with acute non-lymphocytic leukemia — usefulness for epidemiologic prevention and therapeutic research. American Journal of Medicine 1981, 70: 423–431.

    Article  PubMed  Google Scholar 

  14. Schimpff, S. C., Greene, W. H., Young, V. M., Wiernik, P. H. Significance ofPseudomonas aeruginosa in patient with leukemia or lymphoma. Journal of Infectious Diseases 1974, Supplement 130: 24–31.

    Google Scholar 

  15. John, J. F., Sharbaugh, R. J., Bannister, E. R. Enterobacter cloacae, bacteremia, epidemiology and antibiotic resistance. Reviews of Infectious Diseases 1982, 4: 13–28.

    PubMed  Google Scholar 

  16. Markowitz, S. M., Smith, S. M., Williams, D. S. Retrospective analysis of plasmid patterns in a study of burn unit outbreaks of infection due toEnterobacter cloacae. Journal of Infectious Diseases 1983, 148: 18–23.

    PubMed  Google Scholar 

  17. Griffin, H. G., Foster, T. J., Falkiner, F. R., Carr, M. E., Coleman, D. C. Molecular analysis of multiple-resistance plasmids transferred from gram-negative bacteria isolated in a urological unit. Antimicrobial Agents and Chemotherapy 1985, 28: 413–418.

    PubMed  Google Scholar 

  18. Gurwith, M. J., Brunton, J. L., Lank, B. A., Ronald, A. R., Harding, G. K. M. Granulocytopenia in hospitalised patients. American Journal of Medicine 1978, 64: 121–132.

    Article  PubMed  Google Scholar 

  19. Kramer, B. S., Pizzo, P. A., Robichaud, K. J., Witesbsky, F., Wesly, R. Role of serial microbiologic surveillance and clinical evaluation in the management of cancer patients with fever and granulocytopenia. American Journal of Medicine 1982, 72: 561–568.

    Article  PubMed  Google Scholar 

  20. Collignon, P., Munro, R. Management of infection in neutropenic patients. British Medical Journal 1986, 293: 817.

    Google Scholar 

  21. Milligan, D. W., Taylor, M. Management of infection in neutropenic patients. British Medical Journal 1986, 293: 817.

    Google Scholar 

  22. Wells, C. L., Ferrieri, P., Weisdorf, D. J., Rhame, F. S. The importance of surveillance stool cultures during periods of severe neutropenia. Infection Control 1987, 8: 317–319.

    PubMed  Google Scholar 

  23. Meyer, D. V., Winston, D., Young, L. S., Gale, R. P., Martin, W. J. Surveillance cultures in immunosuppressed patients: What do they mean? In: Nelson, J. D., Grassi, C. (ed.): Current chemotherapy and infectious diseases. American Society for Microbiology, Washington, DC, 1980, p. 1436–1437.

    Google Scholar 

  24. Dejace, P., Klastersky, J. Emergence of resistance as a consequence of antimicrobial prophylaxis in immunocompromised patients. Scandinavian Journal of Infectious Diseases 1986, Supplement 49: 165–171.

    Google Scholar 

  25. Wingard, J. R., Dick, J., Charache, P., Saral, R. Antibiotic resistant bacteria in surveillance stool cultures of patients with prolonged neutropenia. Antimicrobial Agents and Chemotherapy 1986, 30: 435–439.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Daw, M.A., Munnelly, P., McCann, S.R. et al. Value of surveillance cultures in the management of neutropenic patients. Eur. J. Clin. Microbiol. Infect. Dis. 7, 742–747 (1988). https://doi.org/10.1007/BF01975040

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01975040

Keywords

Navigation