VALUE OF SURVEILLANCE CULTURES IN TRANSPLANTATION UNIT

Because of the increased risk of infection with the associated diagnos tic and therapeutic problems in bone marrow transplantation (BMT) pati ents, the usefulness of surveillance cultures (SC) at the BMT departme nt of the National Institute of Haematology, Blood Transfusion, Transp lantation and Immunology, Budapest, was reviewed, Between January 1992 and May 1995, 26 BMT operations were performed; 13 patients had 23 fe brile espisodes. In 12 of these episodes infection was clinically docu mented; however, SC of these patients yielded bacteria identical with those in the blood culture in only two episodes (1 and 6 days before t heir blood cultures became positive, respectively), Out of a total of 1187 samples from these patients, potentially pathogenic bacteria were isolated from 145 SC and 43 blood cultures (drawn on 31 different day s), Suppression of the gastrointestinal flora could be achieved by the department's decontamination regimen; however, overgrowth by gram-pos itive organisms (mainly coagulase-negative staphylococci) occurred in the intestine and at other body sites, On the basis of these results, SC are of limited value in predicting infection or identifying the cau sative organisms of fever, On the other hand, SC are useful in confirm ing the efficiency of suppression of the body flora by antimicrobial a gents, Specific treatment was based on suitably sampled materials, and close contact between physicians, infectious disease specialists and microbiologists was essential.