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接受异基因造血干细胞移植的成年患者血流非伤寒沙门氏菌感染的临床相关特征及微生物学特征

Clinical-associated characteristics and microbiological features of bloodstream nontyphoidal salmonella infection in adult patients receiving allogeneic hematopoietic stem cell transplantation.

作者信息

Ko Po-Shen, Liu Yao-Chung, Wang Hao-Yuan, Wu Chia-Yun, Fan Nai-Wen, Liu Chia-Jen, Yu Yuan-Bin, Hsiao Liang-Tsai, Chiou Tzeon-Jye, Tzeng Cheng-Hwai, Liu Jin-Hwang, Gau Jyh-Pyng

机构信息

Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.

Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.

出版信息

Ann Hematol. 2017 Sep;96(9):1533-1540. doi: 10.1007/s00277-017-3054-2. Epub 2017 Jul 15.

Abstract

Bloodstream nontyphoidal salmonella (NTS) infection is rare, but its associated characteristics and microbiological features in immunocompromised patients are worth paying attention to, particularly for those receiving allogeneic hematopoietic stem cell transplantation (SCT). No studies so far have analyzed post-transplant bloodstream NTS infection. Therefore, we reviewed 423 adult patients undergoing allogeneic hematopoietic SCT from 2003 to 2014. Nine out of four hundred twenty-three patients (2.13%) developed post-transplant bloodstream NTS infection, including two patients who had subsequent or combined metastatic infections. The median age at SCT was 35 years (interquartile range, 29-46) among the nine patients with bloodstream NTS infection. Male patients were predominant (78%). The median onset of bloodstream NTS infection was at 315 days after SCT (range, 207-629). Multivariate analysis revealed that extensive chronic graft-versus-host disease (GVHD) (OR 8.054, p = 0.003) and nonmyeloablative transplant conditioning (OR 4.604, p = 0.037) were significant associated characteristics for NTS infection. Currently, there are no published data analyzing and exploring post-transplant bloodstream NTS infections in adult allogeneic hematopoietic SCT. Our study determined the associated characteristics and microbiological features for this infection.

摘要

血流非伤寒沙门氏菌(NTS)感染较为罕见,但其在免疫功能低下患者中的相关特征及微生物学特性值得关注,尤其是对于接受异基因造血干细胞移植(SCT)的患者。目前尚无研究分析移植后血流NTS感染情况。因此,我们回顾了2003年至2014年期间接受异基因造血SCT的423例成年患者。423例患者中有9例(2.13%)发生了移植后血流NTS感染,其中2例随后出现或合并有转移性感染。9例血流NTS感染患者的SCT中位年龄为35岁(四分位间距,29 - 46岁)。男性患者居多(78%)。血流NTS感染的中位发病时间为SCT后315天(范围,207 - 629天)。多因素分析显示,广泛慢性移植物抗宿主病(GVHD)(比值比8.054,p = 0.003)和非清髓性移植预处理(比值比4.604,p = 0.037)是NTS感染的显著相关特征。目前,尚无已发表的数据分析和探讨成年异基因造血SCT后血流NTS感染情况。我们的研究确定了这种感染的相关特征及微生物学特性。

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