Bed isolator for prevention of infection in bone marrow transplantation

Abstract

It is difficult to make newly a laminar air flow room or to reconstruct a room for bone marrow transplantation. We placed a bed isolator in a room of pediatric ward and carried out bone marrow transplantation in 3 patients with acute leukemia. Intestinal and oropharyngeal decontamination was done using 3 drugs of vancomcin, tobramycin, amphotericin B, and strict bed isolator protection was carried out.Gut was decontaminated for aerobic as well as anaerobic bacteria, whereas candida albicans were difficult to eliminate in 1 case.In two patients, who had a difficulty to take oral medication and to carried out oropharyngeal nebulizer, suppression of oral microbial flora were not sufficient.During bed isolator protection, there were no febrile episode in 2 cases. In one patient, stomatitis and febrile episodes likely caused by oropharyngeal bacteria occurred, and these were well managed by using single antibiotics.It was suggested that bed isolator protection had a protective efficacy to prevent bacterial and fungal infection in bone marrow transplantation.