Tasaka T, Nagai M, Sasaki K, Murata M, Taoka T, Ikeda K, Tanaka T, Takahara J, Irino S
First Department of Internal Medicine, Kagawa Medical School, Japan.
Intern Med. 1993 Mar;32(3):221-4. doi: 10.2169/internalmedicine.32.221.
The frequency of streptococcal infections has been reported to be increasing. To determine the significance of such infections complicating treatment of leukemia, we studied the incidence and clinical features of Streptococcus mitis septicemia among 51 leukemia patients in our department. During 166 consecutive treatment courses for leukemia, eight episodes of Streptococcus mitis septicemia were observed in 35 septicemic patients. In seven out of eight episodes (88%), severe mucositis developed after aggressive chemotherapy, suggesting that oral mucosa might be the site of entry for Streptococcus mitis. The isolates were sensitive to imipenam/cilastatin and cefuzonam, and were relatively resistant to amikacin. Although none of the patients died of Streptococcus mitis septicemia, life-threatening adult respiratory distress syndrome (ARDS) developed in two independent treatment courses. We should thus be aware of the risk of ARDS in patients with Streptococcus mitis septicemia.
据报道，链球菌感染的频率一直在上升。为了确定此类感染在白血病治疗中所起的作用，我们研究了我科51例白血病患者中缓症链球菌败血症的发病率和临床特征。在166个连续的白血病治疗疗程中，35例败血症患者出现了8次缓症链球菌败血症发作。在8次发作中的7次（88%），在积极化疗后出现了严重的粘膜炎，这表明口腔粘膜可能是缓症链球菌的侵入部位。分离出的菌株对亚胺培南/西司他丁和头孢唑肟敏感，对丁胺卡那霉素相对耐药。虽然没有患者死于缓症链球菌败血症，但在两个独立的治疗疗程中出现了危及生命的成人呼吸窘迫综合征（ARDS）。因此，我们应该意识到缓症链球菌败血症患者发生ARDS的风险。
