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Influence of Selective Bowel Decontamination on the Organisms Recovered During Bacteremia in Neutropenic Patients

Published online by Cambridge University Press:  02 January 2015

Florian Daxboeck ,
Werner Rabitsch ,
Alexander Blacky ,
Maria Stadler ,
Paul A. Kyrle ,
Alexander M. Hirschl  and
Walter Koller
Florian Daxboeck*
Affiliation:
Clinical Institute of Hygiene and Medical Microbiology, Division of Hospital Hygiene, Vienna University Hospital, Medical University Vienna, Vienna, Austria
Werner Rabitsch
Affiliation:
Department of Internal Medicine I, Bone Marrow Transplantation Unit, Vienna University Hospital, Medical University Vienna, Vienna, Austria
Alexander Blacky
Affiliation:
Clinical Institute of Hygiene and Medical Microbiology, Division of Hospital Hygiene, Vienna University Hospital, Medical University Vienna, Vienna, Austria
Maria Stadler
Affiliation:
Clinical Institute of Hygiene and Medical Microbiology, Division of Hospital Hygiene, Vienna University Hospital, Medical University Vienna, Vienna, Austria
Paul A. Kyrle
Affiliation:
Department of Internal Medicine I, Division of Hematology, Vienna University Hospital, Medical University Vienna, Vienna, Austria
Alexander M. Hirschl
Affiliation:
Clinical Institute of Hygiene and Medical Microbiology, Division of Clinical Microbiology, Vienna University Hospital, Medical University Vienna, Vienna, Austria
Walter Koller
Affiliation:
Clinical Institute of Hygiene and Medical Microbiology, Division of Hospital Hygiene, Vienna University Hospital, Medical University Vienna, Vienna, Austria
*
Clinical Institute of Hygiene and Medical Microbiology, Division of Hospital Hygiene, Vienna University Hospital, Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
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Abstract

Objective:

To assess the influence of prophylactic selective bowel decontamination (SBD) on the spectrum of microbes causing bloodstream infection (BSI).

Design:

The microbes causing BSI in neutropenic patients of a hematologic ward (HW) and a bone marrow transplantation unit (BMTU), respectively, were compared by retrospective analysis of blood culture results from January 1996 to June 2003.

Setting:

A 30-bed HW (no SBD) and a BMTU including a 7-bed normal care ward and an 8-bed intensive care unit (SBD used) of a 2,200-bed university teaching hospital.

Results:

The overall incidences of bacteremia in the HW and the BMTU were similar (72.6 vs 70.6 episodes per 1,000 admissions; P = .8). Two hundred twenty episodes of BSI were recorded in 164 neutropenic patients of the HW and 153 episodes in 127 neutropenic patients of the BMTU. Enterobacteriaceae (OR, 3.14; CI95, 1.67–5.97; P = .0002) and Streptococcus species (OR, 2.04; CI95, 1.14–3.70; P = .015) were observed more frequently in HW patients and coagulase-negative staphylococci more frequently in BMTU patients (OR, 0.15; CI95, 0.09–0.26; P< .00001). No statistically significant differences were found for gram-negative nonfermentative bacilli (P = .53), Staphylococcus aureus (P = .21), Enterococcus species (P = .48), anaerobic bacteria (P = .1), or fungi (P = .50).

Conclusions:

SBD did not lead to a significant reduction in the incidence of bacteremia, but significant changes in microbes recovered from blood cultures were observed. SBD should be considered when empiric antimicrobial therapy is prescribed for suspected BSI.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 8 , August 2004 , pp. 685 - 689
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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