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[合并血液系统疾病的气单胞菌血症的临床特征及实验室数据分析]

[Clinical features and laboratory data analysis of Aeromonas bacteremia with hematological diseases].

作者信息

Xu C H, Lin Q S, Lyu Y X, Zhu G Q, Tian Z Y, Wang C, Sun F J, Yao H J, Wang C

机构信息

Institute of Hematology & Blood Diseases Hospital, CAMS&PUMC, National Clinical Research Center for Hematological Disorders, Tianjin 300020, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2019 Dec 14;40(12):1035-1039. doi: 10.3760/cma.j.issn.0253-2727.2019.12.013.

Abstract

To investigate the clinical and laboratory features of Aeromonas bacteremia in patients with hematological diseases, and provide evidence for the prevention and treatment of Aeromonas infection. A retrospective study of patients with bloodstream infection of Aeromonas in our hospital from January 2014 to December 2018 was carried out. The clinical characteristics, antimicrobial susceptibility, infection seasons, antimicrobial therapy and evolution were analyzed. A total of 42 patients with hematological diseases had Aeromonas bloodstream infection within 5 years. Among them, 39 cases (92.9%) of bloodstream infection occurred in the stage of neutropenia. The median time of fever was 4 (1-27) d, 22 (52.4%) patients only had fever, 6 (14.3%) with gastrointestinal symptoms (abdominal pain, diarrhea, nausea, upper gastrointestinal bleeding) , 8 (19.0%) with pulmonary infection, 13 (31.0%) with skin and soft tissue infections. Seven patients (16.7%) died with skin and soft tissue infection. The resistance of Aeromonas to carbapenems was 68.3%-70.7%, while the resistance rate to cephalosporins, quinolones and aminoglycosides were less than 10%. Aeromonas bacteremia in patients with hematological diseases mainly occur in the neutropenia stage, usually with symptom like fever. The mortality is increased when accompanied by skin and soft tissue infection. Antibiotic use should be based on susceptibility results, and avoid the use of carbapenems.

摘要

为探讨血液系统疾病患者气单胞菌血症的临床和实验室特征,为气单胞菌感染的防治提供依据。对我院2014年1月至2018年12月气单胞菌血流感染患者进行回顾性研究。分析其临床特征、抗菌药物敏感性、感染季节、抗菌治疗及病情演变。5年内共有42例血液系统疾病患者发生气单胞菌血流感染。其中,39例(92.9%)血流感染发生在中性粒细胞减少阶段。发热中位时间为4(1 - 27)天,22例(52.4%)患者仅有发热,6例(14.3%)有胃肠道症状(腹痛、腹泻、恶心、上消化道出血),8例(19.0%)有肺部感染,13例(31.0%)有皮肤及软组织感染。7例(16.7%)患者死于皮肤及软组织感染。气单胞菌对碳青霉烯类的耐药率为68.3% - 70.7%,而对头孢菌素类、喹诺酮类和氨基糖苷类的耐药率均小于10%。血液系统疾病患者气单胞菌血症主要发生在中性粒细胞减少阶段,通常有发热症状。伴有皮肤及软组织感染时死亡率增加。抗生素使用应依据药敏结果,避免使用碳青霉烯类。

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