Bacterial bloodstream infection in neutropenic adult patients after myeloablative cord blood transplantation: Experience of a single institution in Japan
Bacterial bloodstream infection in neutropenic adult patients after myeloablative cord blood transplantation: Experience of a single institution in Japan
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DOI：
10.1532/ijh97.06179
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发表时间：
2007-04-01
影响因子：
2.1
通讯作者：
Asano, Shigetaka
中科院分区：
文献类型：
--
作者：
Tomonari, Akira;Takahashi, Satoshi;Asano, Shigetaka
细菌感染是非相关脐带血移植术后发病和死亡的重要原因之一。在本研究中，我们研究了101例成人患者在CBT后30天内细菌血流感染（BSI）的发生率、结局和危险因素，采用清髓调理方案。12例患者在CBT后30天内发生细菌性BSI。细菌性BSI的累积发病率为12%。中位发病时间为CBT后第6天（范围：第1天至第13天）。所有患者在细菌性BSI发病时中性粒细胞计数均为0/ μ L。革兰氏阳性菌8株（67%），革兰氏阴性菌4株（33%）。12例细菌性BSI患者中只有2例（17%）在CBT后100天内死亡。CBT后30天内未发现细菌性BSI发生的危险因素。在我们的研究中，中性粒细胞减少期细菌性BSI的低死亡率似乎与第100天移植相关死亡的低发生率（6%）有关。早期诊断细菌性BSI和及时有效的抗生素治疗是必要的中性粒细胞减少的成人患者在清髓性CBT后。
Bacterial infection is one of the most important causes of morbidity and mortality after unrelated cord blood transplantation (CBT). In the present study, we studied 101 adult patients with respect to the incidence, outcome, and risk factors for bacteria] bloodstream infection (BSI) within 30 days after CBT using a myeloablative conditioning regimen. Bacterial BSI occurred in 12 patients within 30 days after CBT. The cumulative incidence of bacterial BSI was 12%. The median time of onset was day +6 (range, day -1 to day +13) after CBT. In all patients, the neutrophil count was 0/mu L at the onset of bacterial BSI. Eight (67%) and 4 (33%) of the isolates were Gram-positive and Gram-negative bacteria, respectively. Only 2 (17%) of the 12 patients who had bacterial BSI died within 100 days after CBT. No risk factors for the occurrence of bacterial BSI within 30 days after CBT were identified. The low mortality rate for bacterial BSI in the neutropenic period appeared to be associated with the low incidence (6%) of transplantation-related death at day +100 in our study patients. Early diagnosis of bacterial BSI and prompt treatment with effective antibiotics are necessary for neutropenic adult patients after myeloablative CBT.