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[选择性消化道去污对接受强化化疗的恶性血液病的影响]

[The effect of selective decontamination on malignant hematologic diseases treated with aggressive chemotherapy].

作者信息

Kubesová H, Bobulová D, Mayer J, Vorlícek J

机构信息

II. interní klinika FNsP Brno-Bohunice.

出版信息

Vnitr Lek. 1993 Apr;39(4):364-70.

PMID:8351865
Abstract

The authors analyzed the course of 100 cycles of chemotherapy administered on account of haematological oncological disease: 66 cycles with administration of selective decontamination and 34 without its administration. Based on an analysis of the gut flora they provided evidence of the necessity of concurrent administration of originally separately administered antibiotics and of the necessity to replace nystatin by amphotericin B. They found a significant reduction of the incidence of infectious complications, the number of days with a body temperature above 38 and reduced consumption of antibiotics. The authors found a different composition of the agents causing infectious complications--a reduction of the ratio of Gram-negative agents and an increase of Gram-positive agents and fungi and also in increased percentage of fever of unknown origin. By analysis of the sensitivity of the detected microbes to antibiotics the authors assessed changes in the resistance caused by administration of selective decontamination and assessed the order of assumed effectiveness of the tested antibiotics.

摘要

作者分析了因血液肿瘤疾病进行的100个化疗周期的过程:66个周期采用了选择性去污措施,34个周期未采用。基于对肠道菌群的分析,他们提供了证据,证明原本分开使用的抗生素有必要同时使用,以及用两性霉素B替代制霉菌素的必要性。他们发现感染性并发症的发生率显著降低,体温高于38度的天数减少,抗生素消耗量降低。作者发现引起感染性并发症的病原体组成有所不同——革兰氏阴性菌比例降低,革兰氏阳性菌和真菌比例增加,不明原因发热的百分比也增加。通过分析检测到的微生物对抗生素的敏感性,作者评估了选择性去污措施导致的耐药性变化,并评估了所测试抗生素假定有效性的顺序。

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