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• W2510298628 abstract "Neutropenic diets were adopted as a way to decrease the infection risks in immunocompromised individuals, however there have been limited studies evaluating the infection rates of the neutropenic diet compared to a food safety based diet in a pediatric population following HSCT. Neutropenic diets result in significant restriction in the variety and types of foods an individual may eat resulting in adverse effects on a patient's quality of life. Our hypothesis was that the adoption of a food safety based diet (CCHMC BMT diet) would result in greater patient and parent satisfaction, improved quality of life, and improved oral intake without an increase in infection risks. Data was collected on patients who underwent HSCT at Cincinnati Children's Hospital Medical Center (CCHMC) between January 1, 2014 and December 31, 2014. Patients' transplanted January -June 2014 were on a neutropenic diet. Patients transplanted after July 1, 2014 were on the CCHMC BMT Diet. Comparison of the two diets is shown in Table 1. Patients and parents were surveyed on food cravings, what limited patient's ability to eat and drink, and how diet affected patient's quality of life. Surveys were completed in mid-2015 either via an interview during a clinic appointment, via email response or a telephone call. To compare infection risks, we monitored the central line associated blood stream infection (CLABSI) rate during the two 6 month time periods. CLABSIs were measured in infections/1000 line days. Ninety-three patients were transplanted in 2014. Surveys were not requested from patients due to death (20), less than 1 year of age at time of transplant (8), and total TPN dependence (1). Surveys were requested from the remaining patients, as of 25 Sept 2015 surveys were completed by 35 patients/parents. Demographics are shown in Table 2. There was no statistical difference in the demographics between the two groups. Overall there was no difference in the perceived cravings in all the patients/parents surveyed. Nausea remained a persistent problem in both groups. The neutropenic diet had a negative impact on the patient's quality of life when compared to patients who had received the CCHMC BMT Diet (Table 3). Patients perceived that the CCHMC BMT diet was more conducive to being able to eat as requested by the medical team. The CLABSI rate from January to June was 2.38 and 0 from July to December. The CCHMC BMT diet allowed patients to eat a greater variety of food and improved their compliance to the dietary intake as requested by the medical team without any increase in CLASBI rate. Patients and parents reported higher satisfaction with the CCHMC BMT diet. We plan to continue to use the CCHMC BMT Diet as our standard diet. The role of neutropenic diet for patients undergoing HSCT is likely of little benefit and may hinder a patient's ability to maintain adequate intake.Table 1Neutropenic Diet versus CCHMC BMT DietNeutropenic DietCCHMC BMT DietNo fresh fruits or vegetables; canned and frozen are allowedFresh fruits and vegetables allowed; must be well washed, without cuts/bruisesPasteurized milk products allowedWell cooked eggs allowedNo soft serve ice cream/frozen yogurt servedfrom bulk machinesNo raw Blue cheesePasteurized milk products allowedWell cooked eggs allowedNo soft serve ice cream/frozen yogurt servedfrom bulk machinesNo raw Blue cheeseMeats/ Fish must be cooked - well done No undercooked or raw meats/seafood No deli counter meatsPackaged lunch meats must be cooked in the microwave for 15 secondsMeats/ Fish cooked to an internal temperature of 165 degrees or higher (meat thermometer given)No undercooked or raw meats/seafood No deli counter meats - packaged lunch meats are okayCooked grains allowed Do not handle raw yeastCooked grains allowed Do not handle raw yeastWell water - only if it is boiledWell water - only if it is boiledNo buffet line mealsNo buffet line mealsFast Food Restaurants - food must be prepared freshFast Food Restaurants - food must be prepared freshNo raw honeyNo raw honeyNo sharing drinks or food with family/friendsNo sharing drinks or food with family/friends Open table in a new tab Table 2Demographic DataNeutropenic DietCCHMC BMT Dietp - ValuePatients1419Age0.53526*1 - 10 year olds91111 - 17 year olds23>18 year olds35Sex1.000ˆMale79Female710Disease Type1.000ˆMalignant710Non-Malignant79Type of Transplant0.486ˆAutologous48Allogenic1011Conditioning Regimen1.000ˆMyeloablalative913Reduced Intensity56Day ANC >50014.212.50.20408*Number of patients with GIGVHD1.000ˆGrade 111Grade 211Grade 310* Mann - Whitney U test.ˆFischer exact test. Open table in a new tab Table 3Quality of Life Questions and AssessmentQuality of Life QuestionsNeverAlmost NeverSometimesOftenAlmost AlwaysDid not being allowed to eat the foods you want to eat affect your ability to eat?Was worrying about what you could eat while undergoing a BMT a source of stress?Was the diet during your BMT difficult to follow/enforce?Did a less restrictive diet allow you to eat more?Did your diet affect the way you were able to eat as requested by your care team? Open table in a new tab" @default.
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• W2510298628 date "2016-03-01" @default.
• W2510298628 modified "2023-09-23" @default.
• W2510298628 title "Let Them Eat! Comparing a Neutropenic Diet to a Food Safety Based Diet in Patients Undergoing Hematopoietic Stem Cell Transplantation (HSCT)" @default.
• W2510298628 doi "https://doi.org/10.1016/j.bbmt.2015.11.379" @default.
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