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Annals of Oncology Advance Access originally published online on September 5, 2007
Annals of Oncology 2007 18(11):1870-1874; doi:10.1093/annonc/mdm351
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© 2007 European Society for Medical Oncology

supportive care

Bloodstream infections in neutropenic patients: early detection of pathogens and directed antimicrobial therapy due to surveillance blood cultures

O. Penack1,*, P. Rempf1, M. Eisenblätter2, A. Stroux3, J. Wagner2, E. Thiel1 and I. W. Blau1

1 Department of Haematology, Oncology, and Transfusion Medicine
2 Institute for Microbiology and Hygiene
3 Department of Clinical Epidemiology and Statistics, Campus Benjamin Franklin, Charité, University of Medicine, Berlin, Germany

* Correspondence to: O. Penack, MD, Department of Immunology and Medicine Memorial Sloan-Kettering Cancer Center Zuckerman Building, 14th Floor, Room Z-1419, 1275 York Avenue, New York, NY, 10021, USA. Tel: +1-646-888-2317; Fax: +1-646-422-0452; E-mail: penacko{at}mskcc.org

Bloodstream infections (BSIs) are frequent infectious complications in neutropenic patients. In order to determine the efficacy of surveillance blood cultures (BCs) to detect BSIs prior to clinical manifestation we performed a prospective trial. One hundred patients with haematological malignancies and long-term neutropenia following intensive cytotoxic therapies were recruited. BCs were taken thrice weekly during neutropenia. Forty-two patients were diagnosed with BSI. In 18 (43%) of those patients surveillance BC results were positive and identified microorganisms prior to onset of fever. In patients with positive surveillance BCs modification of the clinical management (specific antimicrobial therapy, CVC removal) resulted in a shorter time to defervescence (median 1.5 days) compared with patients with BCs positive after onset of fever (median 3.5 days, P = 0.004). In conclusion we detected causative microorganisms in more than one-third of BSIs prior to onset of clinical manifestation. The impact of surveillance BCs on the outcome has to be assessed in randomized studies.

Key words: blood culture, bloodstream, infection, neutropenia, surveillance

Received for publication March 28, 2007. Revision received June 6, 2007. Accepted for publication June 8, 2007.


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O. Penack, P. Rempf, B. Graf, I. W. Blau, and E. Thiel
Aspergillus galactomannan testing in patients with long-term neutropenia: implications for clinical management
Ann. Onc., May 1, 2008; 19(5): 984 - 989.
[Abstract] [Full Text] [PDF]


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