突破性侵袭性菌感染在Posaconazole在患有血液恶性瘤的患者的预防:一个病例对照研究
Camille Marchetti1, Emmanouil Glampedakis1, Jannik Stemler2,3,4
1Infectious Diseases Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Mycoses
|October 15, 2025
概括
在接受波萨可纳 (POS) 预防的患者中,突破性侵入性菌感染 (bIMI) 显著增加了死亡率. 原因尚不清楚,通常涉及POS敏感的病原体,没有明显的POS暴露不足.
科学领域:
- 菌类学 菌类学是指菌类学.
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
背景情况:
- 可纳 (POS) 预防是预防高风险血液癌症患者侵入性菌感染 (IMI) 的标准.
- 在POS预防中突破性IMI (bIMI),虽然很少见,但死亡率很高.
研究的目的:
- 在接受POS预防的患者中调查bIMI的流行病学,致病因子和结果.
- 为了比较bIMI病例的特征和结果与非bIMI对照患者的POS预防.
主要方法:
- 追溯病例控制研究包括29个bIMI发作和46个对照在瑞士和德国的五家医院.
- 患者在至少7天的POS预防期间已经证明/可能发生bIMI;对照组接受了类似血液状况的POS.
主要成果:
- 侵袭性阿斯伯吉洛症 (52%) 和粘菌菌 (31%) 是最常见的两种BIMI.
- 14%的bIMI是由POS不敏感的病原体引起的;在39%的病例中,POS暴露不足,与对照组相似.
- 与对照组相比,bIMI患者的整体死亡率明显较高 (52%对20%);手术与生存有关.
结论:
- bIMI显著增加了POS预防的血液癌症患者的死亡率.
- 对bIMI的确切原因是多因素的,并且与POS暴露不足没有明确的联系,即使与可能敏感的病原体.
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