Sacar Suzan, Hacioglu Sibel Kabukcu, Keskin Ali, Turgut Huseyin
Department of Clinical Microbiology and Infectious Diseases, Pamukkale University Faculty of Medicine, Kinikli, Denizli, Turkey.
J Infect Dev Ctries. 2008 Oct 1;2(5):359-63. doi: 10.3855/jidc.197.
Infectious complications in febrile neutropenic patients are still major causes of morbidity and mortality despite significant advances in diagnostic techniques and antimicrobial therapy. In this study, we describe the characteristics of patients with hematological malignancies who were evaluated for suspected infection. This study was also conducted to assess the isolation rate of bacterial and fungal causative agents in febrile neutropenic attacks.
The study was conducted at Pamukkale University Hospital, Turkey. In order to identify the characteristics of patients with hematological malignancies in the presence/suspicion of any accompanying infectious disease, patients' charts with hematological malignancies were reviewed for signs/symptoms of any infection between October 1, 2001, and May 31, 2005, retrospectively.
Overall, 90 infectious episodes occurred in 59 patients. The most common underlying diseases were acute myelogenous leukemia (61.0%) and acute lymphocytic leukemia (15.3%). The absolute neutrophil count was lower than 100/mm(3) in 33 (36.7%) episodes. Microbiologically and clinically documented infections and fever of unknown origin were observed in 35.6%, 28.9%, and 35.6% of the participants, respectively. Bloodstream infections and pneumonia were detected in 21.1% and 18.9% of episodes, respectively. Gram negative organisms were most common (58.4%), followed by gram positive cocci. A combination of third generation cephalosporin and an aminoglycoside were used in 44.4% of episodes initially. Fever resolved in 24.4% of episodes using the initial therapy. The mortality rate was 15.6%.
These results showed that infections with gram-negative bacteria continue to predominate in febrile neutopenic episodes in our center.
尽管诊断技术和抗菌治疗取得了显著进展，但发热性中性粒细胞减少患者的感染并发症仍然是发病和死亡的主要原因。在本研究中，我们描述了接受疑似感染评估的血液系统恶性肿瘤患者的特征。本研究还旨在评估发热性中性粒细胞减少发作中细菌和真菌病原体的分离率。
该研究在土耳其代尼兹利卡帕多西亚大学医院进行。为了确定存在/怀疑伴有任何传染病的血液系统恶性肿瘤患者的特征，回顾性分析了2001年10月1日至2005年5月31日期间血液系统恶性肿瘤患者病历中的任何感染体征/症状。
总体而言，59例患者发生了90次感染发作。最常见的基础疾病是急性髓系白血病（61.0%）和急性淋巴细胞白血病（15.3%）。33次（36.7%）发作的绝对中性粒细胞计数低于100/mm³。分别有35.6%、28.9%和35.6%的参与者出现了微生物学和临床记录的感染以及不明原因发热。分别有21.1%和18.9%的发作检测到血流感染和肺炎。革兰氏阴性菌最常见（58.4%），其次是革兰氏阳性球菌。最初44.4%的发作使用了第三代头孢菌素和氨基糖苷类药物联合治疗。24.4%的发作使用初始治疗后发热消退。死亡率为15.6%。
这些结果表明，革兰氏阴性菌感染在我们中心的发热性中性粒细胞减少发作中仍然占主导地位。
