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. 1986 Sep;30(3):435–439. doi: 10.1128/aac.30.3.435

Antibiotic-resistant bacteria in surveillance stool cultures of patients with prolonged neutropenia.

J R Wingard, J Dick, P Charache, R Saral
PMCID: PMC180575  PMID: 3640591

Abstract

The value of stool surveillance for antibiotic-resistant gram-negative bacteria was analyzed in 86 neutropenic bone marrow transplant patients. Twice-weekly specimens were inoculated onto culture medium containing gentamicin plus carbenicillin. The recovered organisms were identified to the species level and tested for antibiotic susceptibility. Forty-eight resistant organisms were recovered from 35 patients. Thirteen isolates persistently colonized patients. Escherichia coli (29%) and Pseudomonas aeruginosa (19%) were the most frequently recovered organisms. Although most organisms were recovered while patients were on antibiotics, 15 isolates, including eight of nine resistant P. aeruginosa, were detected before antibiotics were initiated. The duration of antibiotic use was longer for patients persistently colonized than for those not colonized (P = 0.03). Of the 15 resistant organisms which caused infection, 12 were detected in the surveillance cultures. Infections by antibiotic-resistant organisms occurred more frequently in patients colonized than in those not colonized (P = 0.006) and more frequently in patients persistently colonized than in those colonized only once (P = 0.01). The absence of colonization or persistent colonization correlated well with the absence of infection (negative predictive values of 94 and 91%, respectively).

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bodey G. P. Oral antibiotic prophylaxis in protected environment units: effect of nonabsorbable and absorbable antibiotics on the fecal flora. Antimicrob Agents Chemother. 1972 Apr;1(4):343–347. doi: 10.1128/aac.1.4.343. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bodey G. P., Rosenbaum B. Effect of prophylactic measures on the microbial flora of patients in protected environment units. Medicine (Baltimore) 1974 May;53(3):209–228. doi: 10.1097/00005792-197405000-00004. [DOI] [PubMed] [Google Scholar]
  3. Bodey G. P., Rosenbaum B. Microbiological monitoring of protected environment units. Effects of antibiotic prophylaxis and type of unit. Eur J Cancer. 1980 Jan;16(1):67–75. doi: 10.1016/0014-2964(80)90109-7. [DOI] [PubMed] [Google Scholar]
  4. Fainstein V., Rodriguez V., Turck M., Hermann G., Rosenbaum B., Bodey G. P. Patterns of oropharyngeal and fecal flora in patients with acute leukemia. J Infect Dis. 1981 Jul;144(1):10–18. doi: 10.1093/infdis/144.1.10. [DOI] [PubMed] [Google Scholar]
  5. Greene W. H., Moody M., Schimpff S., Young V. M., Wiernik P. H. Pseudomonas aeruginosa resistant to carbenicillin and gentamicin. Epidemiologic and clinical aspects in a cancer center. Ann Intern Med. 1973 Nov;79(5):684–689. doi: 10.7326/0003-4819-79-5-684. [DOI] [PubMed] [Google Scholar]
  6. Gurwith M. J., Brunton J. L., Lank B. A., Ronald A. R., Harding G. K. Granulocytopenia in hospitalized patients: I. Prognostic factors and etiology of fever. Am J Med. 1978 Jan;64(1):121–126. doi: 10.1016/0002-9343(78)90187-0. [DOI] [PubMed] [Google Scholar]
  7. Jolley M. E., Stroupe S. D., Wang C. H., Panas H. N., Keegan C. L., Schmidt R. L., Schwenzer K. S. Fluorescence polarization immunoassay. I. Monitoring aminoglycoside antibiotics in serum and plasma. Clin Chem. 1981 Jul;27(7):1190–1197. [PubMed] [Google Scholar]
  8. Levine A. S., Siegel S. E., Schreiber A. D., Hauser J., Preisler H., Goldstein I. M., Seidler F., Simon R., Perry S., Bennett J. E. Protected environments and prophylactic antibiotics. A prospective controlled study of their utility in the therapy of acute leukemia. N Engl J Med. 1973 Mar 8;288(10):477–483. doi: 10.1056/NEJM197303082881001. [DOI] [PubMed] [Google Scholar]
  9. Preisler H. D., Goldstein I. M., Henderson E. S. Gastrointestinal "sterilization" in the treatment of patients with acute leukemia. Cancer. 1970 Nov;26(5):1076–1081. doi: 10.1002/1097-0142(197011)26:5<1076::aid-cncr2820260516>3.0.co;2-d. [DOI] [PubMed] [Google Scholar]
  10. Schimpff S. C., Young V. M., Greene W. H., Vermeulen G. D., Moody M. R., Wiernik P. H. Origin of infection in acute nonlymphocytic leukemia. Significance of hospital acquisition of potential pathogens. Ann Intern Med. 1972 Nov;77(5):707–714. doi: 10.7326/0003-4819-77-5-707. [DOI] [PubMed] [Google Scholar]
  11. Sleijfer D. T., Mulder N. H., de Vries-Hospers H. G., Fidler V., Nieweg H. O., van der Waaij D., van Saene H. K. Infection prevention in granulocytopenic patients by selective decontamination of the digestive tract. Eur J Cancer. 1980 Jun;16(6):859–869. doi: 10.1016/0014-2964(80)90140-1. [DOI] [PubMed] [Google Scholar]
  12. de Vries-Hospers H. G., Sleijfer D. T., Mulder N. H., van der Waaij D., Neiweg H. O., van Saene H. K. Bacteriological aspects of selective decontamination of the digestive tract as a method of infection prevention in granulocytopenic patients. Antimicrob Agents Chemother. 1981 May;19(5):813–820. doi: 10.1128/aac.19.5.813. [DOI] [PMC free article] [PubMed] [Google Scholar]

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