Valteau D, Hartmann O, Brugieres L, Vassal G, Benhamou E, Andremont A, Kalifa C, Lemerle J
Service de Pédiatrie, Institut Gustave-Roussy, Villejuif, France.
Bone Marrow Transplant. 1991 Jun;7(6):415-9.
A total of 251 patients were given 326 courses of high-dose chemotherapy followed by autologous bone marrow transplantation between February 1979 and August 1988. Ninety-one cases of septicaemia developed in 84 patients, 33 of these cases (36%) were due to streptococci. The outcome was fatal for four patients (12.1%). No specific risk factors were identified which might account for this septicaemia and no clinical feature was significantly associated with these cases of bacterial infection. Pulmonary and neurologic septic complications, however, were of very poor prognosis since all patients with these complications died. The high rate of streptococcal septicaemia and the poor outcome for patients with prolonged and profound neutropenia led us to modify our choice of initial broad-spectrum antibiotic therapy.
1979年2月至1988年8月期间，共有251例患者接受了326个疗程的大剂量化疗，随后进行自体骨髓移植。84例患者发生了91例败血症，其中33例（36%）由链球菌引起。4例患者（12.1%）死亡。未发现可解释这种败血症的特定危险因素，也没有临床特征与这些细菌感染病例显著相关。然而，肺部和神经系统败血症并发症的预后非常差，因为所有患有这些并发症的患者均死亡。链球菌败血症的高发生率以及长期和严重中性粒细胞减少患者的不良预后促使我们改变初始广谱抗生素治疗的选择。
