ADENOVIRUS INFECTIONS IN PATIENTS UNDERGOING BONE-MARROW TRANSPLANTATION
ADENOVIRUS INFECTIONS IN PATIENTS UNDERGOING BONE-MARROW TRANSPLANTATION
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DOI：
10.1056/nejm198502283120901
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发表时间：
1985-01-01
影响因子：
158.5
通讯作者：
MEYERS, JD
中科院分区：
文献类型：
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作者：
SHIELDS, AF;HACKMAN, RC;MEYERS, JD
骨髓移植后常可观察到病毒感染。从1976-1982年间接受骨髓移植的1051例患者中分离出51例腺病毒。在46株可供分型的菌株中，有13株(27.7%)属于近缘种11、34或35(B亚属)。所有13名患有这些细菌的患者的尿培养均为阳性。该物种与获得性免疫缺陷综合症或肾移植有关，但在社区调查中并不常见。51例患者中有10例经活检或尸检证实为侵袭性感染。在这10人中，有7人从肺部分离到病毒，4人死于腺病毒肺炎。在5例肾分离株患者中，2例有病毒引起的肾损害的证据，两例肝分离株患者都有腺病毒肝炎。没有解释这些腺病毒感染的共同来源，最有可能的感染源似乎是内源性病毒重新激活。发生感染和严重疾病的唯一可识别的危险因素是中到重度移植物抗宿主疾病的存在。
Viral infection is commonly observed after bone-marrow transplantation. Adenovirus was isolated from 51 of 1051 patients undergoing marrow transplantation between 1976 and 1982. Of the 46 isolates available for typing, 13 (27.7%) were of the closely related species 11, 34 or 35 (subgenus B). All 13 of the patients with these species had positive urine cultures. The species is associated with the acquired immunodeficiency syndrome or with renal transplantation, but are not commonly found in community surveys. Invasive infection was confirmed by biopsy or autopsy in 10 of 51 patients. Of the 10, seven had virus isolated from lung and 4 died from pneumonia attributed to adenovirus. Of the 5 patients with renal isolates, 2 had evidence of virally induced renal impairment and both patients with liver isolates had adenovirus hepatitis. There was no common source that accounted for these adenovirus infections and the most likely source of infection appeared to be endogenous viral reactivation. The only identifiable risk factor for the development of infection and for severe disease was the presence of moderate to severe graft vs. host disease.