Lactobacillus bacteremia in febrile neutropenic patients in a cancer hospital
Lactobacillus bacteremia in febrile neutropenic patients in a cancer hospital
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DOI：
10.1086/598365
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发表时间：
1998-05-01
影响因子：
11.8
通讯作者：
Cobian, L
中科院分区：
文献类型：
--
作者：
Cooper, CD;Vincent, A;Cobian, L
本文对22例H. 1988年1月至1996年6月，美国佛罗里达坦帕的Lee Moffitt癌症中心和研究所。其中男9例，女13例，平均年龄45.2岁（17-69岁）。独立比例检验表明，急性髓性白血病患者中菌血症的发生率（9/162，6.01%）显著高于医院登记处的所有其他患者（13/9047，0.1%;P=0.0001）。可能的危险因素分布如下：中性粒细胞减少，91.0%;粘膜炎+中性粒细胞减少，36.4%;万古霉素治疗，95.5%。发生前常用抗生素为万古霉素（95.5%）、头孢他啶（63.8%）、妥布霉素（63.8%）、甲硝唑（59.1%）、氨曲南（45.5%）、阿昔洛韦（45.5%）、氟康唑（40.9%）。本研究中已知对乳酸杆菌有活性并在诊断后使用的抗生素为克林霉素（54.5%）、青霉素（27.3%）、红霉素（27.3%）和至少2种上述药物（40.9%）。近三分之一（31.8%）的患者没有接受任何有效的抗生素治疗。
A review was carried out on the charts of 22 patients admitted to the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida, USA, between January 1988 and June 1996. There were 9 males and 13 females; the mean age was 45.2 years (range, 17-69 years).Lactobacillus caseiwas isolated from the blood of all patients and from the urine of one. A test for independent proportions indicated that bacteraemia was significantly more frequent (9 (6.01%) of 162) among patients with acute myelogenous leukaemia than among all others in the hospital registry (13 (0.1%) of 9047;P=0.0001). The distribution of probable risk factors was as follows: neutropenia, 91.0%; mucositis plus neutropenia, 36.4%; and vancomycin therapy, 95.5%. Antibiotics frequently used before lactobacillus bacteraemia occurred included vancomycin (95.5%), ceftazidime (63.8%), tobramycin (63.8%), metronidazole (59.1%), aztreonam (45.5%), aciclovir (45.5%) and fluconazole (40.9%). Antibiotics known to be active againstLactobacillusand used after diagnosis in this study were clindamycin (54.5%), penicillin (27.3%), erythromycin (27.3%), and at least 2 of the foregoing drugs (40.9%). Nearly one-third (31.8%) of the patients were not treated with any antibiotic effective againstLactobacillus.