Risk Factors for Infections of the Oropharynx and the Respiratory Tract in Patients with Acute Leukemia

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Abstract
The pathogenicity of microorganisms isolated by surveillance cultures, the neutrophil count in the peripheral blood, and the interaction of the two factors were analyzed as risk factors for infections of the oropharynx and the respiratory tract in patients with acute leukemiabeingtreated in strict reverse isolationunder antimicrobial modulation. A statistical method was developed for the identification of bacteria, the presence of which was correlated with an increased risk of infection. A significantly increased risk was found mainly for species of Klebsiella, Enterobacter, Proteus, and Pseudomonas. The degree of neutropeniawassignificantly correlatedwith the risk of infection, which was influenced by the microbiologic state of the oropharynx. Thus, patients with gram negative bacilli had significantly more days with infection at all levels of neutropenia than patients without gram-negative bacilli. Thesetwo risk factors were additive but did not potentiate each other.