A survey of the use of low microbial diets in pediatric bone marrow transplant programs

A survey was used to determine the use of low microbial diets for pediatric bone marrow transplantation patients at hospitals in Canada and the northwestern United States. Five out of 7 hospitals responding to the survey provided a low microbial diet to this population to reduce the potential risk posed by food pathogens. Two hospitals prepared their low microbial diet in a separate kitchen using aseptic techniques. One hospital provided a diet consisting of well-cooked foods or foods containing a minimum number of pathogen-forming units. Another hospital focused on safe food-handling guidelines, avoiding foods associated with foodborne illness. A final hospital reported using a modified house diet that excluded fresh fruits and vegetables. Various guidelines were used to determine when to initiate and discontinue the low microbial diet. These guidelines included criteria such as a specific day relative to transplantation and a patient's absolute neutrophil count. Results indicate that most hospitals acknowledge the potential for food to cause infection in patients with compromised immune systems by imposing dietary restrictions to limit pathogen exposure.