Outbreaks of infectious diseases in stem cell transplant units: a silent cause of death for patients and transplant programmes
Outbreaks of infectious diseases in stem cell transplant units: a silent cause of death for patients and transplant programmes
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DOI：
10.1038/sj.bmt.1704380
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发表时间：
2004-03-01
影响因子：
4.8
通讯作者：
Cordonnier, C
中科院分区：
文献类型：
--
作者：
McCann, S;Byrne, JL;Cordonnier, C
都柏林国家血液和骨髓移植中心因爆发耐万古霉素肠球菌感染而关闭后，EBMT 进行了一项调查，调查 1991 年至 2001 年 10 年间 SCT 单位感染暴发的发生情况以及对患者发病率、死亡率和移植计划管理的影响。共有 13 个中心报告了 23 起感染暴发，涉及231 名患者：报告了 10 起细菌疫情、8 起病毒疫情和 5 起真菌疫情，56 人因感染死亡。所有真菌和细菌死亡以及大多数病毒死亡都发生在同种异体移植受者中。据报道，在所有疫情中，感染都是在医院获得的，而在所有病毒感染和一半细菌感染中，交叉感染是一个主要因素。所有病毒爆发、十起细菌爆发中的四起和五起真菌爆发中的三起都发生在 HEPA 过滤室中。共有 12 个 SCT 单位报告部分或全部关闭。 JACIE 等强制性质量管理体系的引入应会导致人们对“事件报告”态度的改变，并且与未来的调查一起应减少 SCT 单位中传染病爆发的发生率。
Following the closure of the National Blood and Bone Marrow Transplant Unit in Dublin, because of an outbreak of vancomycin-resistant enterococcal infection, a survey was carried out by the EBMT to investigate the occurrence of outbreaks of infection in SCT units and the impact on patient morbidity, mortality and the administration of the transplant programme over a 10-year period from 1991 to 2001. A total of 13 centres reported 23 outbreaks of infection involving 231 patients: 10 bacterial, eight viral and five fungal outbreaks were reported and 56 deaths were attributed to infection. All fungal and bacterial deaths and the majority of viral deaths occurred in allograft recipients. In all outbreaks, the infection was reported to be hospital acquired and in all the viral, and half the bacterial infections, cross-infection was a major factor. All viral, four of 10 bacterial and three of five fungal outbreaks occurred in HEPA filtered rooms. A total of 12 SCT units reported a partial or total closure. The introduction of mandatory quality management systems such as JACIE should result in a change in attitude to 'incident reporting' and together with future surveys should reduce the incidence of infectious outbreaks in SCT units.