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[Early septicemia episodes in 143 bone marrow grafts]
G Marit1, J Texier, J Reiffers
1Unité de Greffe de Moelle Osseuse, Hôpital du Haut-Levêque, France.
Pathologie-Biologie
|September 1, 1988
Summary
Early bacteremia in allogeneic bone marrow transplant patients is often caused by Gram-positive cocci, primarily coagulase-negative staphylococci. Vancomycin addition to gut decontamination did not reduce Gram-positive bacteremia rates.
Area of Science:
- Hematology
- Infectious Diseases
- Microbiology
Context:
- Allogeneic bone marrow transplantation (BMT) is a complex procedure with a significant risk of early infections.
- Bacteremia, particularly before engraftment, poses a serious threat to BMT recipients.
- Understanding the causative pathogens and evaluating infection prevention strategies are crucial for improving outcomes.
Purpose:
- To analyze the incidence and causative agents of early bacteremia in allogeneic BMT recipients.
- To evaluate the effectiveness of vancomycin as an adjunct to total gut decontamination in preventing Gram-positive bacteremia.
- To assess the impact of isolation in laminar air flow rooms on infection frequency and severity.
Summary:
- Twenty-one cases of early bacteremia were reported in 143 allogeneic BMT recipients before engraftment.
- Gram-positive cocci, predominantly coagulase-negative staphylococci (62%), were the most common pathogens.
- Vancomycin adjunction to total gut decontamination did not significantly reduce Gram-positive bacteremia.
- Isolation in laminar air flow rooms appeared to reduce infection severity but not frequency.
Impact:
- Findings suggest current prophylactic regimens may not be fully effective against Gram-positive bacteremia in this population.
- Laminar air flow may mitigate infection severity, highlighting its potential role in supportive care.
- Further research is needed to optimize antimicrobial prophylaxis and infection control measures in allogeneic BMT.