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针对克雷伯菌和铜绿假单胞菌感染的免疫预防。联邦高免疫免疫球蛋白试验研究组。

Immunoprophylaxis against klebsiella and pseudomonas aeruginosa infections. The Federal Hyperimmune Immunoglobulin Trial Study Group.

作者信息

Donta S T, Peduzzi P, Cross A S, Sadoff J, Haakenson C, Cryz S J, Kauffman C, Bradley S, Gafford G, Elliston D, Beam T R, John J F, Ribner B, Cantey R, Welsh C H, Ellison R T, Young E J, Hamill R J, Leaf H, Schein R M, Mulligan M, Johnson C, Abrutyn E, Griffiss J M, Slagle D

机构信息

VA Medical Center, Boston, Massachusetts 02130, USA.

出版信息

J Infect Dis. 1996 Sep;174(3):537-43. doi: 10.1093/infdis/174.3.537.

Abstract

To determine if passive immunization could decrease the incidence or severity of Klebsiella and Pseudomonas aeruginosa infections, patients admitted to intensive care units of 16 Department of Veterans Affairs and Department of Defense hospitals were randomized to receive either 100 mg/kg intravenous hyperimmune globulin (IVIG), derived from donors immunized with a 24-valent Klebsiella capsular polysaccharide plus an 8-valent P. aeruginosa O-polysaccharide-toxin A conjugate vaccine, or an albumin placebo. The overall incidence and severity of vaccine-specific Klebsiella plus Pseudomonas infections were not significantly different between the groups receiving albumin and IVIG. There was some evidence that IVIG may decrease the incidence (2.7% albumin vs. 1.2% IVIG) and severity (1.0% vs. 0.3%) of vaccine-specific Klebsiella infections, but these reductions were not statistically significant. The trial was stopped because it was statistically unlikely that IVIG would be protective against Pseudomonas infections at the dosage being used. Patients receiving IVIG had more adverse reactions (14.4% vs. 9.2%).

摘要

为了确定被动免疫是否可以降低克雷伯菌属和铜绿假单胞菌感染的发生率或严重程度,对16家退伍军人事务部和国防部医院重症监护病房收治的患者进行随机分组,分别接受100mg/kg静脉注射高效价免疫球蛋白(IVIG)或白蛋白安慰剂,其中IVIG来自接种24价克雷伯菌荚膜多糖加8价铜绿假单胞菌O多糖-毒素A结合疫苗的供体。接受白蛋白和IVIG的两组患者中,疫苗特异性克雷伯菌属和铜绿假单胞菌感染的总体发生率和严重程度无显著差异。有证据表明IVIG可能会降低疫苗特异性克雷伯菌感染的发生率(白蛋白组为2.7%,IVIG组为1.2%)和严重程度(白蛋白组为1.0%,IVIG组为0.3%),但这些降低无统计学意义。该试验提前终止,因为按照所使用的剂量,IVIG在统计学上不太可能对铜绿假单胞菌感染起到保护作用。接受IVIG的患者不良反应更多(14.4%比9.2%)。

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