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造血干细胞移植患者血流感染流行病学的系统评价。

Systematic review on epidemiology of in bloodstream infection of patients undergoing hematopoietic stem cell transplantation.

作者信息

Janani Fatemeh, Azami Pouria, Sanani Mohammad Ghenaatpisheh, Bamneshin Khadijeh

机构信息

PhD, Reproductive Health, Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Postal Code: 6813833946, Iran.

MD, Cardiovascular Research Center, Shiraz University of Medical Sciences, Khalili St, JGH7+R72, Postal Code: 1435916471, Shiraz, Iran.

出版信息

Germs. 2024 Mar 31;14(1):85-94. doi: 10.18683/germs.2024.1420. eCollection 2024 Mar.

Abstract

INTRODUCTION

We aimed to conduct a systematic review of the epidemiology of in bloodstream infections (BSI) of hematopoietic stem cell transplantation patients.

METHODS

For a comprehensive search of studies that reported the prevalence of and antibiotic resistance in bloodstream infections from 2000 to January 1, 2024, databases such as PubMed, EMBASE, Google Scholar, Scopus, and Web of Science were searched. The main keywords used were: , epidemiology, bloodstream infection, microbial resistance, antibiotic resistance, hematopoietic malignancy, hematopoietic stem cell transplantation. After applying eligibility criteria, and quality assessment of studies, data analysis was done by comprehensive meta-analysis (CMA) software.

RESULTS

The prevalence of bacterial bloodstream infections amongst different studies varied between 8-51%. Also, bloodstream infections caused by varied between 2.5-57%. Prevalence of extended-spectrum β-lactamases (ESBLs) of in bloodstream infections varied between 15-80%. As well, the mortality rate caused by strains in bloodstream infection varied between 6.7-27.3%. Resistance to ciprofloxacin, cefepime, third- and fourth-generation cephalosporins, was reported to be the highest (prevalence of 100%), and the lowest was against amikacin, with a prevalence between 13-38%.

CONCLUSIONS

The high prevalence of -related BSI, and subsequent mortality, especially by multidrug resistance and ESBL strains, in patients undergoing hematopoietic stem cell transplantation, requires essential measures to prevent the spread of microbial resistance.

摘要

引言

我们旨在对造血干细胞移植患者血流感染(BSI)的流行病学进行系统综述。

方法

为全面检索2000年至2024年1月1日期间报告血流感染患病率及抗生素耐药性的研究,检索了PubMed、EMBASE、谷歌学术、Scopus和科学网等数据库。使用的主要关键词为:[病原体名称]、流行病学、血流感染、微生物耐药性、抗生素耐药性、造血恶性肿瘤、造血干细胞移植。在应用纳入标准并对研究进行质量评估后,通过综合荟萃分析(CMA)软件进行数据分析。

结果

不同研究中细菌血流感染的患病率在8%至51%之间。此外,[病原体名称]引起的血流感染在2.5%至57%之间。血流感染中[病原体名称]的超广谱β-内酰胺酶(ESBLs)患病率在15%至80%之间。同样,血流感染中[病原体名称]菌株导致的死亡率在6.7%至27.3%之间。据报道,对环丙沙星、头孢吡肟、第三代和第四代头孢菌素的耐药率最高(患病率为100%),对阿米卡星的耐药率最低,患病率在13%至38%之间。

结论

在接受造血干细胞移植的患者中,与[病原体名称]相关的BSI患病率高,以及随后的死亡率,尤其是多重耐药和ESBL菌株导致的死亡率,需要采取必要措施来防止微生物耐药性的传播。

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