Ohmagari Norio, Hanna Hend, Graviss Linda, Hackett Brenda, Perego Cheryl, Gonzalez Virginia, Dvorak Tanya, Hogan Holly, Hachem Ray, Rolston Kenneth, Raad Issam
Division of Infectious Diseases, Shizuoka Cancer Center, Shizuoka, Japan.
Cancer. 2005 Jul 1;104(1):205-12. doi: 10.1002/cncr.21115.
Pseudomonas aeruginosa is responsible for a wide range of infections. In immunocompromised patients with cancer, the emergence of multidrug resistant P. aeruginosa may have grave consequences.
Patients with cancer who were infected with multidrug-resistant P. aeruginosa with polyclonal DNA restriction patterns were used as the case group. Two control groups were used: one group of cancer patients who were infected with multidrug-susceptible P. aeruginosa and another group of cancer patients who had the same underlying disease and the same intensive care unit exposure as patients in the case group but who were not infected or colonized by P. aeruginosa.
Risk factors that were associated significantly with multidrug-resistant P. aeruginosa infection were the use of carbapenem for > or = 7 days, a history of P. aeruginosa infection during the preceding year, and a history of chronic obstructive pulmonary disease (P < 0.01).
Carbapenems may need to be used more judiciously as first-line empirical therapy for cancer patients with prior pseudomonal infection or chronic obstructive pulmonary disease who require hospitalization, and alternative, antipseudomonal antibiotic regimens may need to be considered, especially in this patient population.
铜绿假单胞菌可引发多种感染。在免疫功能低下的癌症患者中，多重耐药铜绿假单胞菌的出现可能会产生严重后果。
将感染具有多克隆DNA限制模式的多重耐药铜绿假单胞菌的癌症患者作为病例组。设置两个对照组：一组为感染对多种药物敏感的铜绿假单胞菌的癌症患者，另一组为与病例组患者患有相同基础疾病且在重症监护病房暴露情况相同但未感染或定植铜绿假单胞菌的癌症患者。
与多重耐药铜绿假单胞菌感染显著相关的危险因素为碳青霉烯类药物使用≥7天、前一年有铜绿假单胞菌感染史以及慢性阻塞性肺疾病史（P<0.01）。
对于既往有假单胞菌感染或慢性阻塞性肺疾病且需要住院治疗的癌症患者，作为一线经验性治疗可能需要更谨慎地使用碳青霉烯类药物，可能需要考虑使用替代性的抗假单胞菌抗生素方案，尤其是在这类患者群体中。
