Liu K L, Herbrecht R, Lioure B, Jaulhac B, Maloisel F, Dufour P, Bergerat J P, Oberling F
Service d'Onco-Hématologie, Hôpital de Hautepierre, Strasbourg, France.
Bone Marrow Transplant. 1995 Jan;15(1):65-9.
The efficacy of gastrointestinal decontamination in reducing the incidence of severe bacterial or fungal infections and of moderate to severe acute graft-versus-host disease (GVHD) has been suggested. We report here a retrospective study of 71 patients grafted consecutively in our institution with bone marrow from HLA genotypically identical siblings. Complete decontamination (plastic isolator or laminar airflow room, sterile nursing and oral antimicrobial drugs) was carried out in all patients. Sixty eight patients were evaluable. Only six patients had aerobic Gram negative rods or anaerobic bacteria in their faeces and 44 of 68 (65%) had yeasts in their faeces. Most patients had oropharyngeal and/or nasal colonisation with bacteria (Gram positive cocci: 39 patients (57%); Gram negative rods: 13 patients (19%)) or yeasts (29 patients (43%)). Thirty nine patients (57%) experienced severe grade > or = II acute GVHD (grade II-IV). A significant relation was found between bacterial oropharyngeal or nasal colonisation and GVHD (P < 0.01) but not between gastrointestinal microflora and GVHD, whatever microorganisms were considered (bacteria, yeasts).
胃肠道去污在降低严重细菌或真菌感染以及中度至重度急性移植物抗宿主病（GVHD）发生率方面的疗效已得到提示。我们在此报告一项对71例在本机构连续接受来自HLA基因分型相同同胞的骨髓移植患者的回顾性研究。所有患者均进行了彻底去污（塑料隔离器或层流空气室、无菌护理和口服抗菌药物）。68例患者可进行评估。仅6例患者粪便中有需氧革兰阴性杆菌或厌氧菌，68例中有44例（65%）粪便中有酵母菌。大多数患者口咽和/或鼻腔有细菌（革兰阳性球菌：39例患者（57%）；革兰阴性杆菌：13例患者（19%））或酵母菌（29例患者（43%））定植。39例患者（57%）发生了严重的≥II级急性GVHD（II - IV级）。发现口咽或鼻腔细菌定植与GVHD之间存在显著相关性（P < 0.01），但无论考虑何种微生物（细菌、酵母菌），胃肠道微生物群与GVHD之间均无相关性。
