[恶性血液病中性粒细胞减少患者的感染并发症。279例中性粒细胞减少症的前瞻性研究]

[Infectious complications in neutropenic patients with malignant hemopathies. A prospective study of 279 cases of neutropenia].

作者信息

Berenguer J, Díaz Mediavilla J, Martínez R, Fernández A, del Potro E, Muñoz P

机构信息

Servicios de Microbiología Clínica, Hospital Universitario de San Carlos, Madrid.

出版信息

Med Clin (Barc). 1990 Oct 20;95(13):481-5.

PMID:2084424

Abstract

We prospectively evaluated the infective complications in 279 neutropenic episodes which developed during the treatment of 79 patients with malignant hemopathies over a 35 month period. In 150 episodes (53.73%) infections were detected: one infection in 121 episodes and two in 29 episodes. Overall 179 infections were detected. 75 of them (41.89%) were considered as possible, 57 (31.84%) were microbiologically documented with bacteremia/fungemia 24 (13.40%) were clinically documented, and 23 (12.84%) were microbiologically documented without bacteremia/fungemia. The portal of entry could not be identified in 121 infections (67.59%), 26 (14.76%) originated in the skin and soft tissues, 14 (7.82%) in the lung, 7 (3.91%) in the oropharynx, 5 (2.79%) in a catheter, and 6 (3.33%) were of miscellaneous origin. Of 80 microbiologically documented infections, 39 (48.75%) were due to gram-negative bacteria, 23 (28.75%) to gram-positive bacteria, 12 (15%) to fungi, and 6 (7.5%) to polymicrobial flora. The overall mortality rate was 4.3%. It was 8% for episodes complicated by infection and 0 in episodes of neutropenia without infection.

摘要

我们前瞻性评估了79例恶性血液病患者在35个月治疗期间发生的279次中性粒细胞减少发作中的感染并发症。在150次发作（53.73%）中检测到感染：121次发作有1次感染，29次发作有2次感染。总共检测到179次感染。其中75次（41.89%）被认为可能是感染，57次（31.84%）有微生物学证据证实为菌血症/真菌血症，24次（13.40%）有临床证据证实，23次（12.84%）有微生物学证据证实但无菌血症/真菌血症。121次感染（67.59%）无法确定感染入口，26次（14.76%）起源于皮肤和软组织，14次（7.82%）起源于肺部，7次（3.91%）起源于口咽，5次（2.79%）起源于导管，6次（3.33%）起源不明。在80次有微生物学证据证实的感染中，39次（48.75%）由革兰氏阴性菌引起，23次（28.75%）由革兰氏阳性菌引起，12次（15%）由真菌引起，6次（7.5%）由多种微生物菌群引起。总死亡率为4.3%。感染并发症发作的死亡率为8%，无感染的中性粒细胞减少发作的死亡率为0。