Department of Microbiology and Immunology, University Hospitals Leuven, Leuven, Belgium.
Support Care Cancer. 2012 Nov;20(11):3013-7. doi: 10.1007/s00520-012-1557-x. Epub 2012 Aug 9.
The aim of our study was to evaluate the frequency of "occult" bacteremia/fungemia as well as the diversity of pathogens involved in hematology patients treated with corticosteroids.
Daily surveillance blood cultures were taken from patients treated with corticosteroids as part of their intensive chemotherapy or during graft-versus-host disease following hematopoietic stem cell transplantation during a 3-year period (2006-2009). We reviewed the frequency of occult bacteremia/fungemia as well as the pathogens involved.
During the 3-year period, 3,821 bottles were cultured from 215 patients and 4.9 % of the bottles tested were positive. Surveillance blood cultures revealed bloodstream infection in 24 % of the patients (definite bloodstream infection in 16 %). Seventy-five percent of patients were still afebrile when microorganisms were detected. The main risk group was acute lymphocytic leukemia patients undergoing remission induction chemotherapy. The pathogens cultured most frequently were coagulase-negative staphylococci, enterococci, Escherichia coli, and Pseudomonas aeruginosa.
A high incidence of occult bacteremia was detected by surveillance blood cultures. Further studies are needed to evaluate if a strategy based on surveillance blood cultures can reduce mortality related to bloodstream infections.
我们的研究旨在评估接受皮质类固醇治疗的血液系统疾病患者中“隐匿性”菌血症/真菌血症的频率以及相关病原体的多样性。
在 3 年期间（2006-2009 年），对接受强化化疗或造血干细胞移植后移植物抗宿主病期间接受皮质类固醇治疗的患者进行每日监测血培养。我们回顾了隐匿性菌血症/真菌血症的频率以及涉及的病原体。
在 3 年期间，对 215 名患者的 3821 瓶进行了培养，其中 4.9%的瓶检测结果为阳性。监测血培养显示 24%的患者存在血流感染（明确的血流感染占 16%）。当检测到微生物时，75%的患者仍未发热。主要的风险群体是接受缓解诱导化疗的急性淋巴细胞白血病患者。最常培养的病原体是凝固酶阴性葡萄球菌、肠球菌、大肠杆菌和铜绿假单胞菌。
通过监测血培养检测到隐匿性菌血症的发生率较高。需要进一步研究评估基于监测血培养的策略是否可以降低与血流感染相关的死亡率。
