Noriega L M, Van der Auwera P, Daneau D, Meunier F, Aoun M
Servicio Medecina Interna, Hospital Dipreca, Los Condes, Santiago, Chile.
Support Care Cancer. 1994 Mar;2(2):116-22. doi: 10.1007/BF00572093.
Data concerning 40 patients hospitalized in a cancer center and Salmonella infection were analyzed. Hematological malignancy was present in 24 patients (60%) and solid tumor in 14 patients (35%). Among the predisposing factors, antineoplastic chemotherapy was the most frequent (60%) followed by antacid use (47.5%), corticosteroids (37.5%), granulocytopenia below 500 neutrophils/microliters (15%), surgery (10%) and splenectomy (2.5%). Bacteremia was the most frequent clinical syndrome accounting for 42.5% of the patients. Focal infection, enteritis and carrier state accounted for the remaining 30%, 20% and 7.5% respectively. Salmonella typhimurium and S. dublin represented 65% of the isolates, with clear association between serotype dublin and bacteremia. All S. dublin isolates were resistant to chloramphenicol. Among dublin and typhimurium serotypes, 20% the isolates were resistant to the traditional antibiotics used in salmonellosis (ampicillin, chloramphenicol, cotrimoxazole). All strains were susceptible in vitro to cephalosporins. The frequency of relapse was 15% and the overall mortality (within 30 days) attributed to Salmonella infection was 15%.
对某癌症中心收治的40例沙门氏菌感染患者的数据进行了分析。24例患者(60%)患有血液系统恶性肿瘤,14例患者(35%)患有实体瘤。在诱发因素中,抗肿瘤化疗最为常见(60%),其次是使用抗酸剂(47.5%)、皮质类固醇(37.5%)、中性粒细胞低于500/微升的粒细胞减少症(15%)、手术(10%)和脾切除术(2.5%)。菌血症是最常见的临床综合征,占患者的42.5%。局灶性感染、肠炎和带菌状态分别占其余的30%、20%和7.5%。鼠伤寒沙门氏菌和都柏林沙门氏菌占分离株的65%,都柏林血清型与菌血症之间存在明显关联。所有都柏林沙门氏菌分离株对氯霉素耐药。在都柏林和鼠伤寒血清型中,20%的分离株对用于治疗沙门氏菌病的传统抗生素(氨苄青霉素、氯霉素、复方新诺明)耐药。所有菌株在体外对头孢菌素敏感。复发率为15%,沙门氏菌感染导致的总体死亡率(30天内)为15%。