[Clinical evaluation of surveillance culture in cancer patients]

To clarify usefulness of surveillance culture (SC) as a predictor of infection, we retrospectively studied 70 episodes of bacteremia in 271 cancer patients between April, 1984 and April, 1988. SC was obtained from the throat swabs, stool and urine on admission and then once weekly during hospitalization. Of 76 aerobic strains from blood, 18 (24%) were isolated from SC prior to bacteremia. Seven strains were first identified from SC within 4 days before bacteremia occurred. Of 63 cases of bacteremia, excluding polymicrobial bacteremia, 14 (22%) were initially detected by SC. An antibiotic therapy was altered within 5 days after bacteremia in 19 bacteremic patients with negative SC and 5 with positive SC. Six bacteremic patients with negative SC and 3 with positive SC died within 5 days after the onset of bacteremia. No significant differences were observed in antibiotic therapy (chi 2 test, p less than 0.05) or mortality (p greater than 0.05) between patients who had positive and negative SC. Routine SC is unlikely to influence an initial diagnosis or antimicrobial management for cancer patients with fever.