CONTINUOUS-MONITORING BLOOD CULTURE SCREENING SYSTEM IMPROVES THE DETECTION OF BACTEREMIA IN NEUTROPENIC PATIENTS

One reason for the underdiagnosis of bacteremia as an etiology of feve r in neutropenic patients might Lie in inefficient blood culture techn iques. This possibility was investigated in a retrospective study by c omparing the efficacies of a manual and an automated blood culture sys tem used to detect bacteremia in such patients. All neutropenic fewer episodes accompanying all 93 intensive chemotherapy cycles of 26 conse cutive patients with acute myelogenous leukemia (AML) enrolled in Finn ish Leukemia Group AML 86 trial and treated in Oulu University Hospita l over 31/2 years were analyzed. The chemotherapy protocol and the sup portive care of the patients remained the same during the whole period . In 1990-91 the blood cultures were made manually and in 1992-93 with an automated continuous-monitoring culture screening system. Evaluabl e febrile episodes numbered 53 during 1990-91 and 73 during 1992-93. T here was a statistically significant increase (p < 0.05) of culture-po sitive episodes, from 21% to 40%, when the continuous-monitoring syste m was adopted. The new method proved to be better than the manual one in detecting bacteremia of neutropenic patients.