Low frequency of enteric infections by Salmonella, Shigella, Yersinia and Campylobacter in patients with acute leukemia.
BACKGROUND
Several authors found that isolation of Salmonella, Shigella, Yersinia and Campylobacter spp. (SSYC) from stool cultures after the 3rd day of hospitalization is a rare event. The significance of enteric infections caused by these pathogens has not been systematically investigated in severely immunosuppressed patients with acute leukemia.


METHODS
We screened all patients treated on the leukemia ward of a university medical center. A total of 1,185 stool cultures from 371 episodes of diarrhea, mostly following myelosuppressive chemotherapy, were examined for the complete range of classic bacterial enteric pathogens (i.e. SSYC).


RESULTS
Only three (0.25%) cultures from one patient were positive for Salmonella enteritidis. This patient suffered from cholangitis. S. enteritidis could also be detected by liver biopsy. Other infections by classic enteric pathogens were not observed.


CONCLUSIONS
Symptomatic infections by classic bacterial enteric pathogens in hospitalized patients with acute leukemia are very rare. Stool cultures for these pathogens cannot be recommended as a routine test in uncomplicated diarrhea occurring after the 3rd hospital day.
Gorschlüter
M
M
Dept of Internal Medicine I, University of Bonn, Germany. gorschlueter@uni-bonn.de
Hahn
C
C
Ziske
C
C
Mey
U
U
Schöttker
B
B
Molitor
E
E
Becker
S
S
Marklein
G
G
Sauerbruch
T
T
Schmidt-Wolf
I G H
IG
Glasmacher
A
A
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002167:Campylobacter / Q000302:isolation & purification; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D006760:Hospitalization; D006801:Humans; D007938:Leukemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012475:Salmonella / Q000302:isolation & purification; D012760:Shigella / Q000302:isolation & purification; D015007:Yersinia / Q000302:isolation & purification