在没有诺基诺预防的当代队列中,AML诱导化疗期间的感染
S Ehrlich1, J Eufinger2, N Tahiri2
1Department of Medicine III, University Hospital Munich - Campus Großhadern, Munich, Germany. sabine.ehrlich@med.uni-muenchen.de.
Infection
|October 1, 2025
概括
在接受诱导化疗的急性髓性白血病 (AML) 患者中,常规抗菌预防可能不需要. 这项研究发现严重的细菌感染和耐药性率较低,这表明需要个性化预防策略.
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:
- 感染是诱导化疗期间急性髓性白血病 (AML) 患者发病和死亡的主要原因.
- 虽然抗真菌预防是标准的,但由于耐药性和不良影响,常规抗菌预防的必要性仍在争论中.
研究的目的:
- 评估AML患者的传染性并发症,在没有常规抗菌预防的情况下接受诱导化疗.
- 在这个队列中描述发烧发作的发生率,记录的感染和死亡率.
主要方法:
- 在2019-2022年期间治疗的103名成年AML患者的回顾性分析.
- 患者接受了抗真菌但不是诺基诺 (FQ) 抗菌预防.
- 评估的结果包括发烧发作,记录的感染,ICU入院和30/90天死亡率.
主要成果:
- 几乎所有患者都经历了发烧发作.
- 临床和微生物学记录的感染分别发生在29.8%和22.9%的发烧事件中.
- 在罕见的多药性耐药性Gram-阳性和Gram-阴性病原体之间,细菌血症平衡;侵入性真菌感染发生在6.8%中.
结论:
- 感染在AML诱导治疗中构成了重大挑战.
- 应该重新考虑诺基诺的预防,偏好个性化方法.
- 新型诊断工具对于高风险AML患者的及时和有针对性的感染管理至关重要.
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