Forty-eight patients with acute leukaemia in relapse (n = 14), acute leukaemia in complete remission (n = 19), chronic myeloid leukaemia (n = 8) or severe aplastic anaemia (n = 7) received a marrow transplant. The first 26 patients were nursed in laminar-air-flow plastic isolators while the next 22 patients were treated in barrier nursing rooms. Gnotobiotic parameters and morbidity in the 2 groups are compared. Good decontamination of the gastro-intestinal tract was obtained using either of the 2 isolation techniques. The incidence of bacterial and mycotic infections, as well as the supportive care required by the patients was almost equal in both groups. Our results also suggest that the incidence of graft versus host disease may decrease with efficient decontamination of the patients.
Technical factors preclude the use of conventional fermentation and assimilation procedures for the routine laboratory differentiation of yeast-like fungal isolates. Commercial biochemical differentiation systems are therefore used to remedy this situation. The predictive accuracy of three commercially available differentiation systems was tested using 120 yeast-like fungal isolates. The morphological characteristics of these fungal strains were identical in the case of all three differentiation systems. The fungal isolates were correctly identified in 98.3% of cases with Auxacolor, in 90.8% of cases with API 20C AUX and in 76.7% of cases with the Mycotube system. The advantages and disadvantages of these biochemical differentiation systems are discussed.
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