Korean J Pediatr Hematol Oncol.  2005 Oct;12(2):317-324.

Significance of Aseptic Room Reverse Isolation in Febrile Neutropenic Cancer Patients

• Kim YM
• Seo HJ
• Lee KS

Abstract

PURPOSE
The aim of this study is to find out the role of HEPA filter equipped lamina air flow room reverse isolation for the treatment of anticancer drug induced febrile neutropenic patients. METHODS: Antibiotics and antifungal agents were promptly administered to twenty six patients with febrile neutropenic following chemotherapy from January 2003 to July 2005 at the Department of Pediatrics, Kyungpook National University Hospital, Daegu, Korea. And if possible, they were treated in the aseptic room. RESULTS: Nineteen patients recovered and seven patients died of infectious causes among twenty six patients. Fourteen patients had microbiologically defined infection, seven patients had clinically defined infection, and five patients had unexplained fever. The causes of infection were sepsis, pneumonia and urinary tract infection. The etiologic pathogens were Gram negative bacilli, 6 (42.9%) ; Gram positive cocci, 3 (21.4%) ; and fungus, 5 (35.7%). The dead group showed lower leukocyte count and higher CRP than the survived group. All dead patients showed disseminated intravascular coagulation syndrome (DIC). Nine of the ten patients (90%) who were treated in the aseptic room survived and ten of the sixteen patients (62.5%) in the general ward survived. CONCLUSION: The infection-related mortality of febrile neutropenic patients following chemotherapy is influenced by the early and adequate use of antimicrobial agents, DIC, neutrophil count and CRP. The isolation in the aseptic room increased the survival rate, but it was not statistically significant.

Keyword

Febrile neutropenic patients; Anticancer drug; Lamina air flow room; HEPA filter; Aseptic room

MeSH Terms

Anti-Bacterial Agents
Anti-Infective Agents
Antifungal Agents
Dacarbazine
Daegu
Disseminated Intravascular Coagulation
Drug Therapy
Fever
Fungi
Gram-Positive Cocci
Gyeongsangbuk-do
Humans
Korea
Leukocyte Count
Mortality
Neutrophils
Patients' Rooms
Pediatrics
Pneumonia
Sepsis
Survival Rate
Urinary Tract Infections
Anti-Bacterial Agents
Anti-Infective Agents
Antifungal Agents
Dacarbazine