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布拉氏酵母菌在肿瘤血液病患者中的应用经验。

Experience with Saccharomyces boulardii Probiotic in Oncohaematological Patients.

机构信息

Department of Microbiology, Central Clinical Hospital in Warsaw, Warsaw, Poland.

Department of Haematology, Oncology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.

出版信息

Probiotics Antimicrob Proteins. 2018 Jun;10(2):350-355. doi: 10.1007/s12602-017-9332-4.

Abstract

Very few reports have been published to date on the bloodstream infections caused by Saccharomyces spp. in oncohaematological patients, and there are no guidelines on the use of this probiotic microorganism in this population. We describe the use of probiotic preparation containing Saccharomyces boulardii in a large group of oncohaematological patients. We retrospectively analysed the data from 32,000 patient hospitalisations at the haematological centre during 2011-2013 (including 196 haematopoietic stem cell transplant recipients) in a tertiary care university-affiliated hospital. During the study period, 2270 doses of Saccharomyces boulardii probiotic were administered to the oncohaematological patients. In total, 2816 mycological cultures were performed, out of which 772 (27.4%) were positive, with 52 indicating digestive tract colonisation by Saccharomyces spp., mainly in patients with acute myeloid leukaemia (AML), myelodysplastic syndrome (MDS) or multiple myeloma (MM). While colonised, they were hospitalised for 1683 days and 416 microbiological cultures of their clinical samples were performed. In the studied group of patients, there were six blood cultures positive for fungi; however, they comprised Candida species: two C. glabrata, one C. albicans, one C. krusei, one C. tropicalis and one C. parapsilosis. There was no blood culture positive for Saccharomyces spp. Our study indicates that despite colonisation of many oncohaematological patients with Saccharomyces spp., there were no cases of fungal sepsis caused by this species.

摘要

目前仅有少量文献报道过在血液肿瘤患者中由萨氏酵母引起的血流感染,且针对该人群使用这种益生菌微生物制剂也尚无相关指南。我们描述了在一组大型血液肿瘤患者中使用含有布拉氏酵母菌的益生菌制剂的情况。我们对一家三级教学医院血液中心 2011-2013 年期间 32000 例患者住院(包括 196 例造血干细胞移植受者)的数据进行了回顾性分析。研究期间,2270 剂布拉氏酵母菌益生菌被给予血液肿瘤患者。共进行了 2816 次真菌培养,其中 772 次(27.4%)为阳性,52 次提示消化道定植有萨氏酵母,主要发生于急性髓细胞白血病(AML)、骨髓增生异常综合征(MDS)或多发性骨髓瘤(MM)患者。定植时,他们共住院 1683 天,对其临床样本进行了 416 次微生物培养。在研究组患者中,有 6 例血培养真菌阳性,但均为念珠菌属物种:2 例近平滑念珠菌、1 例白念珠菌、1 例克柔念珠菌、1 例热带念珠菌和 1 例近平滑假丝酵母。未发现萨氏酵母血培养阳性。我们的研究表明,尽管许多血液肿瘤患者定植了萨氏酵母,但没有该种酵母引起的真菌性败血症病例。

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