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2015-2017 年,瑞士伯尔尼一项前瞻性研究:自体造血干细胞移植患者的呼吸道病毒感染特征。

Characteristics of respiratory virus infections in autologous hematopoietic stem cell transplantation patients, a prospective study, Bern, Switzerland, 2015-2017.

机构信息

Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.

Department of Medical Oncology, Bern University Hospital, University of Bern, Bern, Switzerland.

出版信息

Infect Dis (Lond). 2021 Apr;53(4):274-280. doi: 10.1080/23744235.2021.1871642. Epub 2021 Jan 21.

Abstract

BACKGROUND

The epidemiology of respiratory virus infections (RVI) in patients undergoing autologous haematopoietic stem cell transplantation (auto-SCT) is not well described.

METHODS

Our goal was to describe the epidemiology of respiratory virus infections (RVI) in patients undergoing autologous haematopoietic stem cell transplantation (auto-SCT) in a single tertiary centre observation study during two respiratory virus seasons (2015-2017). All symptomatic auto-SCT patients were tested for RVI by nasopharyngeal swab.

RESULTS

156 transplantation episodes were included, 69% were male and, the median age was 57 years. We detected 19 RVIs in 156 transplantation episodes (12%). The median time to RVI after hospitalization was 13 days [IQR 7-13] and 15/19 (79%) had a possible nosocomial origin (occurrence ≥ 5 days after admission). The nosocomial infections included 5/15 (33%) 'severe' RVIs (3 influenza viruses, 1 parainfluenza virus, and 1 adenovirus) as well as 10/15 (66%) non-severe virus infections (including human rhinovirus and human coronavirus).

CONCLUSION

In approximately 10% of auto-SCT transplantation episodes, an RVI with likely nosocomial origin was detected and included 'severe viruses' such as influenza. Our study suggests that infection prevention measures in auto-SCT patients can be improved.

ABBREVIATIONS

AdV: adenovirus; ALL: acute lymphatic leukaemia; AML: acute myeloid leukaemia; auto-SCT: autologous haematopoietic stem cell transplantation; hCoV: human coronavirus; HD: Hodgkin's disease; hMPV: human metapneumovirus; HRV: human rhinovirus; HSCT: allogeneic haematopoietic stem cell transplantation; IQR: interquartile range; GCT: germ cell tumour; MM: multiple myeloma; NHL: non-Hodgkin lymphoma; PIV: parainfluenza virus; RSV: respiratory syncytial virus.

摘要

背景

自体造血干细胞移植(auto-SCT)患者呼吸道病毒感染(RVI)的流行病学情况尚未得到充分描述。

方法

在两个呼吸道病毒流行季(2015-2017 年)中,我们在一家三级中心进行了一项观察性研究,对所有出现症状的自体造血干细胞移植患者进行了呼吸道病毒检测。通过鼻咽拭子检测患者的呼吸道病毒感染情况。

结果

共纳入 156 例移植病例,其中 69%为男性,中位年龄为 57 岁。我们在 156 例移植病例中检测到 19 例 RVI(12%)。住院后发生 RVI 的中位时间为 13 天[IQR 7-13],15/19(79%)例可能为医院获得性感染(发病时间在入院后≥5 天)。医院获得性感染包括 5/15(33%)例“严重”RVI(3 例流感病毒、1 例副流感病毒和 1 例腺病毒)和 10/15(66%)例非严重病毒感染(包括人鼻病毒和人冠状病毒)。

结论

约 10%的自体造血干细胞移植病例中,检测到可能源自医院的 RVI,包括流感等“严重病毒”。我们的研究表明,自体造血干细胞移植患者的感染预防措施可以得到改善。

缩写词

AdV:腺病毒;ALL:急性淋巴细胞白血病;AML:急性髓细胞白血病;auto-SCT:自体造血干细胞移植;hCoV:人冠状病毒;HD:霍奇金淋巴瘤;hMPV:人偏肺病毒;HRV:人鼻病毒;HSCT:异基因造血干细胞移植;IQR:四分位间距;GCT:生殖细胞肿瘤;MM:多发性骨髓瘤;NHL:非霍奇金淋巴瘤;PIV:副流感病毒;RSV:呼吸道合胞病毒。

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