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与癌症患者棒状杆菌病相关的微生物学和宿主特征:一项为期五年的研究。

Microbiological and host features associated with corynebacteriosis in cancer patients: a five-year study.

机构信息

Ministério da Saúde, Ministério da Saúde, Rio de Janeiro, RJ, Brasil.

出版信息

Mem Inst Oswaldo Cruz. 2009 Sep;104(6):905-13. doi: 10.1590/s0074-02762009000600015.

Abstract

During a five-year period, 932 clinical isolates from cancer patients treated in a Brazilian reference centre were identified as corynebacteria; 86% of the cultures came from patients who had been clinically and microbiologically classified as infected and 77.1% of these patients had been hospitalised (71.1% from surgical wards). The adult solid tumour was the most common underlying malignant disease (66.7%). The univariate and multivariate analyses showed that hospitalised patients had a six-fold greater risk (OR = 5.5, 95% CI = 1.15-26.30 p = 0.033) related to 30-day mortality. The predominant species were Corynebacterium amycolatum (44.7%), Corynebacterium minutissimum (18.3%) and Corynebacterium pseudodiphtheriticum (8.5%). The upper urinary tracts, surgical wounds, lower respiratory tracts, ulcerated tumours and indwelling venous catheters were the most frequent sources of C. amycolatum strains. Corynebacterium jeikeium infection occurred primarily in neutropenic patients who have used venous catheters, while infection caused by C. amycolatum and other species emerged mainly in patients with solid tumours.

摘要

在五年期间,从巴西一家参考中心治疗的癌症患者中分离出了 932 株棒状杆菌临床分离株;86%的培养物来自临床上和微生物学上被分类为感染的患者,其中 77.1%的患者住院(71.1%来自外科病房)。成人实体瘤是最常见的恶性基础疾病(66.7%)。单因素和多因素分析显示,住院患者与 30 天死亡率相关的风险增加了六倍(OR=5.5,95%CI=1.15-26.30 p=0.033)。主要分离株为糖多孢菌(44.7%)、极小棒状杆菌(18.3%)和假白喉棒状杆菌(8.5%)。上尿路、手术伤口、下呼吸道、溃疡性肿瘤和留置静脉导管是糖多孢菌菌株最常见的来源。C.jeikeium 感染主要发生在使用静脉导管的中性粒细胞减少患者中,而 C.amycolatum 和其他种引起的感染主要发生在实体瘤患者中。

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