Parainfluenza virus type 3 infections in a hematology unit
Parainfluenza virus type 3 infections in a hematology unit
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DOI：
10.1038/sj.bmt.1702776
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发表时间：
2001-02-01
影响因子：
4.8
通讯作者：
Kotilainen, P
中科院分区：
文献类型：
--
作者：
Hohenthal, U;Nikoskelainen, J;Kotilainen, P
副流感病毒3型(PIV3)与有下呼吸道感染的骨髓移植受者的高死亡率有关。我们描述了9例恶性血液病患者(其中5例接受了异基因或自体干细胞移植)，在血液科的2个月期间被鉴定为PIV3感染。4例胸片有浸润性病变的患者接受了静脉注射利巴韦林治疗，全部存活。在两名患者中，感染是社区获得性的，而在其余七名患者中，疾病的医院来源是明显的或推定的。为控制PIV3的传播而实施的政策如下：(1)从所有出现呼吸道症状的患者身上获取用于抗原检测的鼻咽样本；(2)所有确诊(或疑似)PIV3阳性的血液病患者都按照接触隔离预防措施进行护理，最好是在传染病部门；以及(3)对工作人员进行进一步的医院卫生教育。我们的经验表明，通过早期开始静脉注射利巴韦林，有可能避免免疫低下患者中PIV3下呼吸道感染的死亡，也有可能通过实施系统的鼻咽采样以进行快速诊断，以及严格遵守队列和接触隔离预防措施，即使在不关闭病房的情况下，也有可能遏制PIV3的医院传播。
Parainfluenza virus type 3 (PIV3) is associated with a high mortality rate in BMT recipients with lower respiratory tract infections. We describe nine patients with hematological malignancies (five having undergone either allogeneic or autologous stem cell transplantation) identified as having PIV3 infection during a 2-month period in a Hematology Unit. Four patients with infiltrates on chest radiograph received intravenous ribavirin therapy; all survived. The infection was community-acquired in two patients, while nosocomial origin of the disease was evident, or presumed, in the remaining seven. The policy implemented to control the spread of PIV3 was as follows: (1) nasopharyngeal samples for antigen detection were obtained from all patients presenting,vith respiratory symptoms; (2) all diagnosed (or suspected) PIV3-positive hematological patients were nursed following contact isolation precautions, preferably in the Infectious Diseases Unit; and (3) staff were given further education on hospital hygiene. Our experience shows that it may be possible to avoid mortality for PIV3 lower respiratory tract infection in immunocompromised patients by early commencement of intravenous ribavirin, It is also possible, even without closing the ward, to contain nosocomial spread of PIV3 by implementing systematic nasopharyngeal sampling for rapid diagnostics, and by strict adherence to cohorting and contact isolation precautions.