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Infections Post Transplant

Utility of obtaining blood cultures in febrile neutropenic patients undergoing bone marrow transplantation

Bone Marrow Transplantation volume 26, pages 533–538 (2000)Cite this article

Abstract

Infection remains an important cause of morbidity and mortality after bone marrow or stem cell transplantation. To evaluate the role of obtaining blood cultures for intermittent or persistent fever in neutropenic patients on antibiotic therapy, we performed a retrospective chart review of 196 consecutive patients admitted to the Bone Marrow Transplant Unit at the University of North Carolina Hospitals from 1995 to 1998. From the cohort of 196 patients, 154 patients developed neutropenic fever. The initial blood culture was positive in 16 of 145 patients during the first fever episode giving a prevalence of 11%. From the total of 109 patients that had blood cultures drawn after day 1 of fever, five patients had blood cultures positive for a pathogen, a prevalence of 4.6%. In only one patient, did blood cultures drawn after day 1 identify an organism not present on day 1 (prevalence 0.9%). After reviewing the results in the first 105 patients, we changed our timing of collection of blood cultures. Forty-nine patients were treated in this manner and we found that the mean number of blood cultures decreased from 9.2 to 4.7 per patient without a change in the frequency of infectious complications or length of hospitalization. Bone Marrow Transplantation (2000) 26, 533–538.

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References

  1. Lazarus HM . Hematopoietic progenitor cell transplantation in breast cancer: current status and future directions Cancer Invest 1998 16: 102–126

    Article  CAS  Google Scholar 

  2. McGuire WP . High-dose chemotherapy and autologous bone marrow or stem cell reconstitution for solid tumors Curr Prob Cancer 1998 22: 135–177

    Article  CAS  Google Scholar 

  3. Rahman ZU, Hortobagyi GN, Buzdar AU, Champlin R . High-dose chemotherapy with autologous stem cell support in patients with breast cancer Cancer Treat Rev 1998 24: 249–263

    Article  CAS  Google Scholar 

  4. Tallman MS, Gradishar WJ . High-dose chemotherapy and autologous stem cell transplantation as treatment for high-risk breast cancer Cancer Chemother Pharmacol 1998 42: S60–S67

    Article  CAS  Google Scholar 

  5. Faderl S, Kantarjian HM, Talpaz M . Chronic myelogenous leukemia: update on biology and treatment Oncology 1999 13: 169–180; Discussion 181, 184

    PubMed  Google Scholar 

  6. Takaue Y, Kawano Y, Watanabe T, Watanabe A . Transplantation with peripheral blood stem cells, manipulated or unmanipulated, for the treatment of high-risk childhood leukemia Bone Marrow Transplant 1998 22: S1–S6

    Article  Google Scholar 

  7. Finiewicz KJ, Larson RA . Dose-intensive therapy for adult acute lymphoblastic leukemia Semin Oncol 1999 26: 6–20

    CAS  PubMed  Google Scholar 

  8. Waselenko JK, Flynn JM, Byrd JC . Stem-cell transplantation in chronic lymphocytic leukemia: the time for designing randomized studies has arrived Semin Oncol 1999 26: 48–61

    CAS  PubMed  Google Scholar 

  9. Zikos P, Van Lint MT, Lamparelli T et al. Allogeneic hemopoietic stem cell transplantation for patients with high risk acute lymphoblastic leukemia: favorable impact of chronic graft-versus-host disease on survival and relapse Haematologica 1998 83: 896–903

    CAS  PubMed  Google Scholar 

  10. Kipps TJ . Chronic lymphocytic leukemia Curr Opin Hematol 1998 5: 244–253

    Article  CAS  Google Scholar 

  11. Apperley JF . Bone marrow transplant for the haemoglobinopathies: past, present and future Baillières Clin Haematol 1993 6: 299–325

    Article  CAS  Google Scholar 

  12. Sullivan KM, Reid CD . Introduction to a symposium on sickle cell anemia: current results of comprehensive care and the evolving role of bone marrow transplantation Semin Hematol 1991 28: 177–179

    CAS  PubMed  Google Scholar 

  13. Schiodt I, Bergmann OJ, Johnsen HE, Hansen NE . Early infections after autologous transplantation for haematological malignancies Med Oncol 1998 15: 103–108

    Article  CAS  Google Scholar 

  14. Mossad SB, Longworth DL, Goormastic M et al. Early infectious complications in autologous bone marrow transplantation: a review of 219 patients Bone Marrow Transplant 1996 18: 265–271

    CAS  PubMed  Google Scholar 

  15. Tattersall MH, Hutchinson RM, Gaya H, Spiers AS . Empirical antibiotic therapy in febrile patients with neutropenia and malignant disease Eur J Cancer 1973 9: 417–423

    Article  CAS  Google Scholar 

  16. Tattersall MH, Spiers SA, Darrell JH . Initial therapy with combination of five antibiotics in febrile patients with leukaemia and neutropenia Lancet 1972 1: 162–165

    Article  CAS  Google Scholar 

  17. Smith H . Use of antibiotics in patients with leukaemia and neutropenia Lancet 1972 1: 440

    Article  CAS  Google Scholar 

  18. Bambara LM, Celebrano R, Corrocher R, De Sandre G . The local inflammatory response in leukocyte disorders Haematologica 1979 64: 403–415

    CAS  PubMed  Google Scholar 

  19. Hiruki T, Fernandes B, Ramsay J, Rother I . Acute typhlitis in an immunocompromised host. Report of an unusual case and review of the literature Dig Dis Sci 1992 37: 1292–1296

    Article  CAS  Google Scholar 

  20. Ketterer N, Espinouse D, Chomarat M et al. Infections following peripheral blood progenitor cell transplantation for lymphoproliferative malignancies: etiology and potential risk factors Am J Med 1999 106: 191–197

    Article  CAS  Google Scholar 

  21. Rintala E . Incidence and clinical signficance of positive blood cultures in febrile episodes of patients with hematological malignancies Scand J Infect Dis 1994 26: 77–84

    Article  CAS  Google Scholar 

  22. Lew MA, Kehoe K, Ritz J et al. Prophylaxis of bacterial infections with ciprofloxacin in patients undergoing bone marrow transplantation Transplantation 1991 51: 630–636

    Article  CAS  Google Scholar 

  23. Lew MA, Kehoe K, Ritz J et al. Ciprofloxacin vs trimethoprim/sulfamethoxazole for prophylaxis of bacterial infections in bone marrow transplant recipients: a randomized, controlled trial J Clin Oncol 1995 13: 239–250

    Article  CAS  Google Scholar 

  24. Serody JS, Shea TC . Prevention of infections in bone marrow transplant recipients Infect Dis Clin N Am 1997 11: 459–477

    Article  CAS  Google Scholar 

  25. Attal M, Schlaifer D, Rubie H et al. Prevention of gram-positive infections after bone marrow transplantation by systemic vancomycin: a prospective, randomized trial J Clin Oncol 1991 9: 865–870

    Article  CAS  Google Scholar 

  26. Koya R, Andersen J, Fernandez H et al. Analysis of the value of empiric vancomycin administration in febrile neutropenia occurring after autologous peripheral blood stem cell transplants Bone Marrow Transplant 1998 21: 923–926

    Article  CAS  Google Scholar 

  27. Dompeling EC, Donnelly JP, Deresinski SC et al. Early identification of neutropenic patients at risk of gram-positive bacteraemia and the impact of empirical administration of vancomycin Eur J Cancer 1996 32A: 1332–1339

    Article  CAS  Google Scholar 

  28. Raad II, Whimbey EE, Rolston KV et al. A comparison of aztreonam plus vancomycin and imipenem plus vancomycin as initial therapy for febrile neutropenic cancer patients Cancer 1996 77: 1386–1394

    Article  CAS  Google Scholar 

  29. Murray PR, Baron EJ, Pfaller MA . Manual of Clinical Microbiology, 6th edn 1995

  30. Herwaldt LA, Geiss M, Kao C, Pfaller MA . The positive predictive value of isolating coagulase-negative Staphylococci from blood cultures Clin Infect Dis 1996 22: 14–20

    Article  CAS  Google Scholar 

  31. Gray F, Shea T, Wiley J et al. Phase I/II results of cyclophosphamide, VP-16, carboplatin and total body irradiation with autologous stem cell transplantation for hematologic malignancies Blood 1995 86: (Suppl. 1) 947a

    Google Scholar 

  32. Santos GW . Busulfan and cyclophosphamide for marrow transplantation Bone Marrow Transplant 1989 4: (Suppl.) 236–239

    PubMed  Google Scholar 

  33. Hughes WT, Armstrong D, Bodey GP et al. 1997 guidelines for the use of antimicrobial agents in neutropenic patients with unexplained fever. Infectious Diseases Society of America Clin Infect Dis 1997 25: 551–573

    Article  CAS  Google Scholar 

  34. Viscoli C, Bruzzi P, Castagnola E et al. Factors associated with bacteraemia in febrile, granulocytopenic cancer patients. The International Antimicrobial Therapy Cooperative Group (IATCG) of the European Organization for Research and Treatment of Cancer (EORTC) Eur J Cancer 1994 30A: 430–437

    Article  CAS  Google Scholar 

  35. Yuen KY, Woo PC, Hui CH et al. Unique risk factors for bacteraemia in allogeneic bone marrow transplant recipients before and after engraftment Bone Marrow Transplant 1998 21: 1137–1143

    Article  CAS  Google Scholar 

  36. Arns da Cunha C, Weisdorf D, Shu XO et al. Early gram-positive bacteremia in BMT recipients: impact of three different approaches to antimicrobial prophylaxis Bone Marrow Transplant 1998 21: 173–180

    Article  CAS  Google Scholar 

  37. Donnelly JP . Bacterial complications of transplantation: diagnosis and treatment Antimicrob Chemother 1995 36: 59–72

    Article  CAS  Google Scholar 

  38. Elishoov H, Or R, Strauss N, Engelhard D . Nosocomial colonization, septicemia, and Hickman/Broviac catheter-related infections in bone marrow transplant recipients. A 5-year prospective study Medicine 1998 77: 83–101

    Article  CAS  Google Scholar 

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Acknowledgements

This work was supported in part by grant CA-67715 from the National Cancer Institute.

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Author notes

  1. MM Berrey

    Present address: Virology Section, Glaxo Wellcome Research Triangle Park, NC, USA

Authors and Affiliations

  1. Department of Medicine, University of North Carolina School of Medicine and the Division of Laboratory Medicine University of North Carolina Hospitals, USA

    JS Serody, MM Berrey, K Albritton, EP Capel, SH Bigelow, DJ Weber, DA Gabriel & TC Shea

  2. Department of Pediatrics, University of North Carolina School of Medicine and the Division of Laboratory Medicine University of North Carolina Hospitals, USA

    K Albritton, SM O'Brien & JM Wiley

  3. Department of Biostatistics, University of North Carolina School of Medicine and the Division of Laboratory Medicine University of North Carolina Hospitals, USA

    MJ Schell

  4. Department of Microbiology and Immunology, University of North Carolina School of Medicine and the Division of Laboratory Medicine University of North Carolina Hospitals, USA

    JS Serody, SM O'Brien & PH Gilligan

  5. Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA

    TC Shea

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Serody, J., Berrey, M., Albritton, K. et al. Utility of obtaining blood cultures in febrile neutropenic patients undergoing bone marrow transplantation. Bone Marrow Transplant 26, 533–538 (2000). https://doi.org/10.1038/sj.bmt.1702535

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