Funada H, Matsuda T
Protected Environment Unit, Kanazawa University School of Medicine.
Jpn J Clin Oncol. 1995 Jun;25(3):86-90.
During a 22-year period, 13 patients with hematologic diseases developed bacteremia caused by the Bacteroides fragilis group, with a frequency which remained almost unchanged. Nine patients (69%) had polymicrobial infections. Acute leukemia was the most common underlying disease. The lower intestinal tract (necrotizing enterocolitis and anorectal abscesses) was the most common source of infection. Prior antibiotic therapy was the most frequent host condition before bacteremia, followed by cancer chemotherapy, neutropenia, thrombocytopenia and hypoproteinemia. Septic shock occurred only in seven patients with polymicrobial infections. Six patients, including five with shock, died within a week of onset, while the other seven survived for at least three weeks. Despite its clinical similarity to aerobic gram-negative infection, bacteremia due to the B. fragilis group may well, therefore, be suspected particularly when neutropenic patients who present with lower intestinal symptomatology develop a persistent fever unresponsive to the initial empiric antibiotic therapy.
在22年期间，13例血液病患者发生了脆弱拟杆菌群引起的菌血症，其发生率几乎保持不变。9例患者（69%）发生了多微生物感染。急性白血病是最常见的基础疾病。下肠道（坏死性小肠结肠炎和肛门直肠脓肿）是最常见的感染源。在发生菌血症之前，先前的抗生素治疗是最常见的宿主状况，其次是癌症化疗、中性粒细胞减少、血小板减少和低蛋白血症。感染性休克仅发生在7例多微生物感染患者中。6例患者，包括5例休克患者，在发病后一周内死亡，而其他7例存活至少三周。尽管脆弱拟杆菌群引起的菌血症在临床上与需氧革兰氏阴性菌感染相似，但当出现下肠道症状的中性粒细胞减少患者出现持续发热且对初始经验性抗生素治疗无反应时，仍应高度怀疑此病。
