Martino P, Micozzi A, Venditti M, Gentile G, Girmenia C, Raccah R, Santilli S, Alessandri N, Mandelli F
Dipartimento di Biopatologia Umana, Università La Sapienza, Rome, Italy.
Rev Infect Dis. 1990 Mar-Apr;12(2):250-7. doi: 10.1093/clinids/12.2.250.
Bone marrow transplant recipients are at increased risk of severe central venous catheter-related septicemias that may be complicated by endocardial infection. In view of this, we prospectively evaluated 141 consecutive patients receiving allogeneic or autologous bone marrow infusion. Seven (5%) of 141 patients developed eight episodes of a clinical syndrome compatible with catheter-related right-sided infective endocarditis; this diagnosis was confirmed at autopsy in two patients who died. Staphylococcus epidermidis was the most frequent isolate (four cases). Other offending pathogens were, in one case each, Enterococcus faecalis, Corynebacterium jeikeium, Pseudomonas alcaligenes, and Achromobacter xylosoxidans plus Candida species. Three- to 7-week courses of antibacterial therapy were associated with a favorable outcome in six of the seven cases. Infective endocarditis may be a complication of the use of central venous catheters and should be actively sought in septicemic bone marrow transplant recipients.
骨髓移植受者发生严重的中心静脉导管相关败血症的风险增加，这种败血症可能并发心内膜感染。鉴于此，我们前瞻性地评估了141例连续接受异基因或自体骨髓输注的患者。141例患者中有7例（5%）出现了8次符合导管相关右侧感染性心内膜炎临床综合征的发作；在2例死亡患者的尸检中证实了这一诊断。表皮葡萄球菌是最常见的分离株（4例）。其他致病病原体分别为粪肠球菌、杰氏棒状杆菌、产碱假单胞菌、木糖氧化无色杆菌加念珠菌属各1例。7例中有6例接受3至7周疗程的抗菌治疗后预后良好。感染性心内膜炎可能是使用中心静脉导管的并发症，在发生败血症的骨髓移植受者中应积极排查。
