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The Utility of Routine Surveillance Blood Cultures in Asymptomatic Hematopoietic Stem Cell Transplant Patients

Kanathezhath, Bindu MD*; Shah, Ami MD; Secola, Rita RN; Hudes, Mark PhD; Feusner, James H. MD*

Journal of Pediatric Hematology/Oncology: May 2010 - Volume 32 - Issue 4 - p 327-331
doi: 10.1097/MPH.0b013e3181ced36c
Clinical and Laboratory Observations

Introduction Surveillance blood cultures (BCs) are often obtained in hematopoietic stem cell transplant (HSCT) patients for earlier detection of blood stream infections (BSI). The major aim of this study was to determine the utility of the current practice of obtaining surveillance blood cultures from asymptomatic transplant patients upon admission for the preparative regimen.

Methods We conducted an 8-year retrospective study of all patients consecutively admitted to the hospital for a HSCT from 2000 to 2008.

Results In this retrospective analysis, surveillance BCs from 191 eligible patients were analyzed. The incidence of definitive BSIs was 0.52% (1/191) with 6 BCs from other HSCT patients growing probable contaminants. The overall incidence of positive surveillance BCs was 2.9% (7/238) for the BCs taken and 3.7% (7/191) for patients cultured with coagulase negative staphylococcus being isolated from 6 of the 7 patients. The probability of increased BSI after transplantation in patients with initial positive surveillance BCs compared with those having negative BCs, was not significant (P=0.675). No infection-related mortality was observed during the first 60 days posttransplantation in these patients.

Conclusions The frequency of positive surveillance BCs in asymptomatic HSCT patients at the time of hospital admission for transplant seems to be extremely low. These results, if confirmed by larger studies, show the reduced utility of obtaining surveillance BC in asymptomatic patients before administration of the conditioning regimen and the need for re-evaluation of this practice.

*Department of Pediatric Hematology/Oncology, Children's Hospital & Research Institute Oakland

Pediatric Clinical Research Center, Children's Hospital and Research Center, Oakland

Division of Research Immunology/Bone Marrow Transplant, Saban Research Institute, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA

Reprints: Bindu Kanathezhath, MD, Research Associate, Pediatric Hematology/Oncology, Children's Hospital & Research Center Oakland, 747 52nd Street, Oakland, CA 94609 (e-mail:

Received for publication July 31, 2009; accepted December 2, 2009

Dr Kanathezhath is supported by grants from UC Berkeley California Institute of Regenerative Medicine (T1-00007) and Cooley's Anemia Foundation.

© 2010 Lippincott Williams & Wilkins, Inc.