在患有骨髓质疏松综合征的患者中,感染和抗微生物预防
Mary M Czech1, Eduard Schulz2, Alain Mina2
1National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.
Seminars in hematology
|August 28, 2024
概括
传染性并发症在骨髓质疏松症候群 (MDS) 中很常见. 抗菌预防可能有利于高风险的MDS患者在中性质衰竭期间,而抗真菌预防用于持续的中性质衰竭.
科学领域:
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
- 在瘤学瘤学.
背景情况:
- 传染性并发症显著导致骨髓质疏松综合征 (MDS) 的发病率和死亡率.
- 预防感染可以提高MDS患者的生存率和生活质量.
- 在MDS中评估感染和抗微生物预防是具有挑战性的,因为疾病的异质性和不断变化的定义.
研究的目的:
- 审查和总结当前对感染和在骨髓质疏松症候群中抗菌预防的理解.
- 确定MDS患者感染的关键病原体和危险因素.
- 提供关于适当的抗微生物预防策略的指导.
主要方法:
- 文献综述和对MDS感染现有数据的综合.
- 分析感染类型,病原体和危险因素,包括中性质衰竭.
- 评估当前的实践和对抗微生物预防的建议.
主要成果:
- 患有MDS的感染与中性质减退有关,高风险 (HR-MDS) 患者比低风险 (LR-MDS) 患者感染的次数更多.
- 肺炎是最常见的感染,主要是由细菌引起的.
- 侵入性真菌感染 (IFI) 和病毒再激活是罕见的,尽管抗真菌预防用于持续的,严重的中性质衰竭.
结论:
- 对于HR-MDS患者,在严重的中性质衰竭和早期治疗周期期间,可以考虑抗菌预防.
- 针对IFI和病毒再激活的抗菌预防对大多数MDS患者来说通常不那么有益.
- 改善感染和预防的数据收集对于优化MDS患者护理至关重要.
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