抄録
A 5-year-old girl with severe aplastic anemia received a bone marrow transplantation. The transplant was rejected and the patient died of invasive aspergillosis and septicemia due to Enterobacter cloacae. The sequential quantitative fecal flora study demonstrated suppression of all groups of intestinal flora constituents to less than 102/g of feces immediately after initiation of total decontaminative measures. An overgrowth of yeast was observed after 10 days at a level of 107/g feces, despite continual oral antibiotic use. Aspergillus was also isolated at a level of 102/g feces. The overgrowth seemed to be related to the occurrence of invasive aspergillosis in the patient. The partial decontamination utilizing narrow-spectrum antimicrobials, which preserves the colonization resistance of the normal intestinal flora, might be superior to the traditional practice of total decontamination using oral gentamicin, vancomycin, and nystatin.
