Howard D S, Phillips II G L, Reece D E, Munn R K, Henslee-Downey J, Pittard M, Barker M, Pomeroy C
Blood and Marrow Transplant Program, Division of Hematology and Oncology, Lucille Parker Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA.
Clin Infect Dis. 1999 Dec;29(6):1494-501. doi: 10.1086/313514.
We report a 12% incidence of adenovirus infections among 532 recipients of hematopoietic stem cell transplant (HSCT) from January 1986 through March 1997. The median time from day of stem cell infusion to first positive culture was 41 days. Recipients of allogeneic stem cells, as opposed to autologous stem cell recipients, were more likely to have a culture positive for adenovirus (16% vs. 3%; P<.0001). Pediatric patients were also more likely than adults to have a positive culture (23% vs. 9%; P<.0001). Among stem cell recipients with partially matched related donors, pediatric recipients appear to be at significantly greater risk for infection than adult recipients (P<.001). Positive cultures were associated with evidence of invasion in 64% of cases (41 of 64). A multiple logistic regression analysis showed that isolating adenovirus from more than 1 site correlated with greater risk for invasive infections (P=.002). Invasive infections were associated with poorer chance of survival.
我们报告了1986年1月至1997年3月期间532例造血干细胞移植(HSCT)受者中腺病毒感染的发生率为12%。从干细胞输注日到首次培养阳性的中位时间为41天。与自体干细胞受者相比,异基因干细胞受者更有可能腺病毒培养呈阳性(16%对3%;P<0.0001)。儿科患者培养呈阳性的可能性也高于成人(23%对9%;P<0.0001)。在有部分匹配相关供者的干细胞受者中,儿科受者感染风险似乎明显高于成人受者(P<0.001)。64%的病例(64例中的41例)培养阳性与侵袭证据相关。多因素logistic回归分析显示,从多个部位分离出腺病毒与侵袭性感染风险增加相关(P=0.002)。侵袭性感染与生存机会较差相关。