[1]毛蕾,夏冰,田晨,等.自体造血干细胞移植期间腹泻患者艰难梭菌感染及其影响因素分析[J].第三军医大学学报,2019,41(23):2285-2289.
 MAO Lei,XIA Bing,TIAN Chen,et al.Incidence and risk factors for Clostridium difficile infection in patients with diarrhea during autologous hematopoietic stem cell transplantation[J].J Third Mil Med Univ,2019,41(23):2285-2289.
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自体造血干细胞移植期间腹泻患者艰难梭菌感染及其影响因素分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第23期
页码:
2285-2289
栏目:
专题报道
出版日期:
2019-12-15

文章信息/Info

Title:
Incidence and risk factors for Clostridium difficile infection in patients with diarrhea during autologous hematopoietic stem cell transplantation
作者:
毛蕾夏冰田晨赵海丰杨洪亮于泳陈静张翼鷟
300060 天津,天津医科大学肿瘤医院血液科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室
Author(s):
MAO Lei XIA Bing TIAN Chen ZHAO Haifeng YANG Hongliang YU Yong CHEN Jing ZHANG Yizhuo

Department of Hemotology, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, China

关键词:
自体造血干细胞移植艰难梭菌感染发病率危险因素
Keywords:
autologous hematopoietic stem cell transplantation Clostridium difficile infection incidence risk factor
分类号:
R378.8; R442.2; R617.06
文献标志码:
A
摘要:

目的探讨自体造血干细胞移植期间腹泻患者中艰难梭菌感染(Clostridium difficile infection,CDI)发病情况及相关危险因素,为自体造血干细胞移植期间艰难梭菌感染诊治提供思路。方法回顾性分析2009年5月至2019年7月天津医科大学附属肿瘤医院血液科自体造血干细胞移植期间腹泻患者的资料。将艰难梭菌厌氧培养及酶免疫方法检测艰难梭菌毒素A/B结果阳性的患者纳入CDI组,其余患者纳入非CDI组,分析CDI发病情况及相关危险因素。结果自体造血干细胞移植期间共计202例患者发生腹泻,其中33例(16.3%)发生CDI,进入移植病房后中位CDI发生时间为12(8~17)d。单因素分析结果显示白消安、硼替佐米和卡莫司汀为CDI发生的危险因素,多因素分析结果显示白消安和硼替佐米为CDI发生的独立危险因素。CDI患者中位腹泻持续时间为6(4~9)d,2例(6.0%)患者发生感染性休克并死亡。结论自体造血干细胞移植期间CDI发生率较高,白消安与硼替佐米为CDI发生的危险因素。

Abstract:

ObjectiveTo investigate the incidence and risk factors for Clostridium difficile infection (CDI) in patients with diarrhea during autologous hematopoietic stem cell transplantation (auto-HSCT) and provide guidance for clinical diagnosis and treatment. MethodsClinical data of patients with diarrhea during auto-HSCT between May 2005 and July 2019 were collected and retrospectively analyzed. The patients with positive results of Clostridium difficile anaerobic culture and Clostridium difficile toxin A/B test were assigned into the CDI group, and the others were into the non-CDI group. The incidence and risk factors for CDI were analyzed in this case-control study. ResultsA total of 202 patients developed diarrhea during auto-HSCT in this study. Thirty-three patients suffered from CDI, with an incidence rate of 16.3% and a median onset of 12(8~17) d since the admission of transplantation ward. The results of the univariate analysis indicated that the incidence of CDI was associated with the administration of busulfan, bortezomib and carmustine (all P<0.05). The multivariate analysis showed that busulfan and bortezomib were the independent risk factors for CDI (all P<0.05). The median time of diarrhea was 6(4~9) d in CDI patients, and 2 patients (6.0%) developed septic shock and died. ConclusionThe incidence rate of CDI is quite high in the patients with diarrhea during auto-HSCT. The administration of busulfan and bortezomib are risk factors for CDI.

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更新日期/Last Update: 2019-12-09