The incidence of tuberculosis infection in hematopoietic stem cell transplantation recipients: A retrospective cohort study from a center in Turkey
The incidence of tuberculosis infection in hematopoietic stem cell transplantation recipients: A retrospective cohort study from a center in Turkey
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DOI：
10.1111/tid.12912
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发表时间：
2018-08-01
影响因子：
2.6
通讯作者：
Senol, Esin
中科院分区：
文献类型：
--
作者：
Aki, Sahika Zeynep;Sucak, Gulsan Turkoz;Senol, Esin
背景免疫功能低下的潜伏性结核感染（LTBI）患者存在结核病复发的风险，应接受预防治疗。而结核菌素皮肤试验（TST）有局限性，特别是在免疫功能低下的patients.AimsThis回顾性研究进行，以确定结核感染的发病率在成人造血干细胞移植受体的预防性治疗LTBI确定根据有针对性的TST的指导。（287自体和271异基因）谁存活100天后transplantation were included in this analysis. ResultsSculin皮肤试验结果可在493 558移植（88.3%）。TST阴性的发生率为54.5%（269/493例）。1例多发性骨髓瘤患者，有TB病史，TST结果阴性，未接受INH预防治疗，发生TB感染再激活。没有接受INH预防（151 558移植; 27.1%）和224例TST 5 mm的患者没有TB infection.DiscussionDespite作为一个回顾性分析和变量的TST预防阈值的局限性，有一些显着的结果，这项分析。我们在异基因HSCT受者中没有TB感染。阴性TST结果的高发生率可能归因于潜在的免疫缺陷。TST可能不是一个可靠的指南预测TB再激活的风险在血液病patients. ConclusionSculin皮肤试验可能有很高的假阴性和假阳性结果在HSCT收件人。指导LTBI治疗的靶向TST的一般指南可能不适用于所有地区和情况。需要更可靠的方法来预测和治疗这些特定条件下的LTBI。
BackgroundImmune-compromised patients with latent TB infection (LTBI) are at risk for TB reactivation and should receive prophylaxis. Whereas the tuberculin skin test (TST) has limitations particularly in immune-compromised patients.AimsThis retrospective study was conducted to determine the incidence of TB infection in adult HSCT recipients whose preventive therapy for LTBI was determined according to the guidance of targeted TST.Patients and MethodsFive hundred and fifty-eight consecutive HSCT recipients (287 autologous and 271 allogeneic) who survived 100days post-transplantation were included in this analysis.ResultsTuberculin skin test results were available in 493 of 558 transplants (88.3%). The incidence of negative TST was 54.5% (269 of 493 patients). One multiple myeloma patient with a history of TB and negative TST result and was not on INH prophylaxis developed reactivation of TB infection. None of the recipients under INH prophylaxis (151 of 558 transplants; 27.1%) and none of the 224 patients with TST 5mm developed TB infection.DiscussionDespite the limitations of being a retrospective analysis and variable prophylaxis thresholds of TST, there are some remarkable results of this analysis. We had no TB infection in the allogeneic HSCT recipients. The high incidence of negative TST results may be attributed to the underlying immune-deficiency. TST may not be a reliable guide for predicting TB reactivation risk in hematology patients.ConclusionTuberculin skin test may have a high rate of false-negative and false-positive results in HSCT recipients. The general guidelines for targeted TST to guide treatment of LTBI may not apply to all regions and situations. More reliable methods are required to predict and treat LTBI in these specific conditions.