造血干细胞移植后并发早期感染的临床分析

目的为了更好地预防和治疗造血干细胞移植术后感染。方法对31例在1999~2005年间进行自体和异基因造血干细胞移植的患者,总结其移植早期感染及治疗情况。结果共有25例(80%)患者在移植后1~14d出现发热,其中22例占88.0%治疗有效。在患者5个部位共检测出病原体180例次,其中阳性菌69.4%,阴性菌30.6%。排名前3位的的阳性菌和阴性菌分别是表皮葡萄球菌、粪链球菌、屎肠球菌和大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌。结论移植后早期需有效全面监测定殖的病原菌及其药敏,为临床选择抗菌药物提供帮助。

Early Infections in Patients Undergoing Hemopoietic Stem Cell Transplantation

Objective To prevent and treat infections after hemopoietic stem cell transplantation. Methods All the patients received transplantation in Ruijin hospital from 1999 to 2005 were collected for the assessment of infection and treatment in the early post-transplant period. Results Fever occurred in 25 patients(80%) 1 d to 14 d after transplantation, and among them 22 had good effects(88%). Of the 180 events with presence of pathogens in the 5 sites, 69.4% were Gram positive and 30.6% were Gram negative. The most frequently detected Gram positive and Gram negative pathogens were Staphylococcus epidermis, Enterococcus faecium,Streptococcus faecium and Escherichia coli, Klebiella pneumoniae, Pseudomonas aeruginosa, respectively. Conclusion Monitoring of pathogens and drug sensitive tests in the early post-transplant period may help clinical doctors choose suitable antibiotics.