Risk factor analysis for linezolid-associated thrombocytopenia in critically ill patients
Risk factor analysis for linezolid-associated thrombocytopenia in critically ill patients
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DOI：
10.1007/s10096-019-03754-1
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发表时间：
2020-03-01
影响因子：
4.5
通讯作者：
Georges, Bernard
中科院分区：
文献类型：
--
作者：
Cazavet, Julien;Bounes, Fanny Vardon;Georges, Bernard
利奈唑胺是一种用于对抗革兰氏阳性细菌的抗生素，包括耐甲氧西林金黄色葡萄球菌。其主要不良反应是血液毒性。本研究的目的是分析接受利奈唑胺治疗的重症患者发生血小板减少症的风险因素。这是一项纳入72例患者的回顾性单中心研究。治疗开始后，从D 0至D20测量血小板。血小板减少症的危险因素采用多变量logistic回归分析，然后进行Monte Carlo模拟。ROC曲线分析后，基线血小板计数低于108 x 10（9）/L和C-min高于4 mg/L，模拟人群中的比值比分别为117（95% CI [97-206]）和3（95% CI [1.5-6.2]），被确定为风险因素。在合并这2个因素的源人群患者中，发生血小板减少的人数显著较高（66.7% vs. 33.3%，p = 0.0042）。基线血小板计数低于108 x 10（9）/L和C-min高于4 mg/L是接受利奈唑胺治疗的重症患者发生血小板减少症的风险因素。
Linezolid is an antibiotic used against gram-positive bacteria, including methicillin-resistant Staphylococcus aureus. Its primary adverse effect is haematotoxicity. The objective of this study was to analyse the risk factors for onset of thrombocytopenia in critically ill patients treated with linezolid. This was a retrospective, single-centre study of 72 patients. Platelets were measured from D0 to D20 after the start of treatment. The risk factors for thrombocytopenia were identified using a multivariate logistic regression analysis following a Monte Carlo simulation. Following ROC curve analysis, a baseline platelet count lower than 108 x 10(9)/L and a C-min higher than 4 mg/L, with respective odds ratios of 117 (95% CI [97-206]) and 3 (95% CI [1.5-6.2]) in the simulated population, were identified as risk factors. Among the source population patients combining these 2 factors, a significantly higher number developed thrombocytopenia (66.7% vs. 33.3%, p = 0.0042). A baseline platelet count lower than 108 x 10(9)/L and a C-min higher than 4 mg/L are risk factors for the onset of thrombocytopenia in critically ill patients treated with linezolid.