Plastic isolators for treatment of acute leukaemia patients under “germ-free” conditions

British medical journal 01/1976; 4(5996):549-52. DOI: 10.1136/bmj.4.5996.549
Source: PubMed


A gnotobiotic isolation system based on those developed in veterinary research has been constructed for hospital use. Fifteen patients with leukaemia and neutropenia spent a total of 110 weeks in plastic isolators, and none acquired any infection. Endogenous flora was effectively suppressed by topical antiseptics and gastrointestinal decontamination effected with nonabsorbable antibiotics. The isolator system was acceptable to patients and staff and much cheaper than the use of sterile rooms. Other advantages of the system are portability, easy storage, and use on ordinary open wards without prejudice to the microbiological protection afforded. It is as yet uncertain whether protective environments of this type will substantially improve the outcome of treatment for the acute leukaemias.

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    • "Bowel decontamination in the nonelective cases was started in the cubicle, while in the elective cases it began in the isolator. Each patient received a combination of oral antibiotics according to the 'Fracon' regimen devised by Trexler et al. (1975). Administration of nystatin was started 4 days before framycetin and colistin and the doses of all antibiotics were modified according to age. "
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    ABSTRACT: Four children, 5 months to 15 years of age, underwent bone marrow transplantation in Vickers-Trexler isolator tents. Two grafts were elective. During 170 days of isolation no clinical infections due to exogenous micro-organisms developed despite severe immunodeficiency. The decontamination regimen and sterile procedures used, as well as the microbiological results, are described. This form of isolation in paediatric practice was found to be highly acceptable to both patients and staff.
    Archives of Disease in Childhood 08/1977; 52(7):563-8. DOI:10.1136/adc.52.7.563 · 2.90 Impact Factor
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    ABSTRACT: Over the last 5 years plastic isolators have been used for the prevention of infection in patients with severe neutropenia. Fifteen patients in differing stages of acute myeloid and chronic granulocytic leukaemia were managed in isolators for a total of 110 patient-weeks. The mean duration of isolation for each patient was 7·4 weeks with a range of 2-14 weeks. There was no evidence that any of the isolated patients acquired infection with any exogenous micro-organism. The psychological problems of isolation proved less onerous for the patients than had been anticipated by the medical and nursing staff and no patient had to be removed from isolation for psychiatric reasons. Unfortunately the reduced incidence of clinical infection in the isolated patients was not obviously associated with an increase in effectiveness of their anti-leukaemic treatment.
    Postgraduate Medical Journal 10/1976; 52(611):558-92. DOI:10.1136/pgmj.52.611.558 · 1.45 Impact Factor
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    ABSTRACT: A 15-year-old boy with Fanconi's anaemia, who required four units of blood each month, received a bone marrow graft from his 9-year-old brother, who has HLA identical and compatible on mixed lymphocyte reaction. Considerable immunosuppression was used and bacterial infection was prevented by vigorous decontamination in a Vickers-Trexler isolator. After the graft the patient's blood counts remained satisfactory for nine months, but it took six months before qualitative immune function was normal.
    British medical journal 03/1977; 1(6058):420-2. DOI:10.1136/bmj.1.6058.420
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