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[血液系统疾病患者的严重细菌感染]

[Serious bacterial infections in patients with hematologic disorders].

作者信息

Ueda T, Iwasaki H, Kawai Y, Nakamura T

机构信息

First Department of Internal Medicine, Fukui Medical School.

出版信息

Nihon Rinsho. 1994 Feb;52(2):462-7.

PMID:7510347
Abstract

In patients with hematologic disorders, especially, leukemias and lymphomas, complicated bacterial infection frequently becomes serious. Main predisposing factors are (1) the disease and its chemotherapy (2) granulocytopenia and (3) mucosal damage. The site of infection is often unidentified. Two special sites, the oral cavity and central venous catheter, should not be overlooked. The infection is usually treated by empiric therapy. G-CSF is effective for rapid granulocyte recovery. For prophylaxis, the laminar air flow room, oral nonabsorbable antibiotics, and systemic chemoprevention with colonization resistance are recommended. Noteworthy among recent infections are (1) MRSA infection caused by long-term use of third generation cephems and (2) neutropenic enterocolitis, for which the most recommended aid is surgical resection of the lesion.

摘要

在血液系统疾病患者中,尤其是白血病和淋巴瘤患者,复杂的细菌感染常常会变得很严重。主要的易感因素有:(1)疾病本身及其化疗;(2)粒细胞减少;(3)黏膜损伤。感染部位常常难以确定。两个特殊部位,即口腔和中心静脉导管,不应被忽视。感染通常采用经验性治疗。粒细胞集落刺激因子(G-CSF)对粒细胞的快速恢复有效。对于预防,建议使用层流洁净病房、口服不吸收抗生素以及通过定植抗力进行全身化学预防。近期感染中值得注意的是:(1)长期使用第三代头孢菌素引起的耐甲氧西林金黄色葡萄球菌(MRSA)感染;(2)中性粒细胞减少性小肠结肠炎,对此最推荐的辅助治疗是手术切除病变部位。

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