Intensive Care Unit, University Hospital of Toulouse, 1 Avenue Jean Poulhès, 31059, Toulouse Cedex 9, France.
Department of Anesthesiology and Critical Care, University Hospital of Toulouse, TSA 50032, 31059, Toulouse Cedex 9, France.
Eur J Clin Microbiol Infect Dis. 2020 Mar;39(3):527-538. doi: 10.1007/s10096-019-03754-1. Epub 2019 Dec 18.
Linezolid is an antibiotic used against gram-positive bacteria, including methicillin-resistant Staphylococcus aureus. Its primary adverse effect is haematotoxicity. The objective of this study was to analyse the risk factors for onset of thrombocytopenia in critically ill patients treated with linezolid. This was a retrospective, single-centre study of 72 patients. Platelets were measured from D0 to D20 after the start of treatment. The risk factors for thrombocytopenia were identified using a multivariate logistic regression analysis following a Monte Carlo simulation. Following ROC curve analysis, a baseline platelet count lower than 108 × 10/L and a C higher than 4 mg/L, with respective odds ratios of 117 (95% CI [97-206]) and 3 (95% CI [1.5-6.2]) in the simulated population, were identified as risk factors. Among the source population patients combining these 2 factors, a significantly higher number developed thrombocytopenia (66.7% vs. 33.3%, p = 0.0042). A baseline platelet count lower than 108 × 10/L and a C higher than 4 mg/L are risk factors for the onset of thrombocytopenia in critically ill patients treated with linezolid.
利奈唑胺是一种用于治疗革兰氏阳性菌的抗生素，包括耐甲氧西林金黄色葡萄球菌。其主要的不良反应是血液毒性。本研究的目的是分析接受利奈唑胺治疗的危重症患者血小板减少症发生的危险因素。这是一项回顾性、单中心的 72 例患者研究。在治疗开始后第 0 天至第 20 天测量血小板。采用蒙特卡罗模拟的多变量逻辑回归分析确定血小板减少症的危险因素。通过 ROC 曲线分析，在模拟人群中，血小板计数基线低于 108×10/L 和 C 高于 4mg/L 的比值比分别为 117（95%CI [97-206]）和 3（95%CI [1.5-6.2]），被确定为危险因素。在合并这两个因素的源人群患者中，血小板减少症的发生率显著更高（66.7% vs. 33.3%，p = 0.0042）。血小板计数基线低于 108×10/L 和 C 高于 4mg/L 是接受利奈唑胺治疗的危重症患者血小板减少症发生的危险因素。
