https://scholars.lib.ntu.edu.tw/handle/123456789/479963
標題: | Mycobacterial infections in adult patients with hematological malignancy | 作者: | Chen, Chien-Yuan WANG-HUEI SHENG Lai C.-C. Liao C.-H. YU-TSUNG HUANG WOEI TSAY SHANG-YI HUANG JIH-LUH TANG HWEI-FANG TIEN PO-REN HSUEH |
公開日期: | 2012 | 卷: | 31 | 期: | 6 | 起(迄)頁: | 1059-1066 | 來源出版物: | European Journal of Clinical Microbiology and Infectious Diseases | 摘要: | We retrospectively analyzed the clinical and microbiological characteristics of adult patients with hematological malignancy and nontuberculous mycobacteria (NTM) infections from 2001 to 2010. During the study period, 50 patients with hematological malignancy and tuberculosis (TB) were also evaluated. Among 2,846 patients with hematological malignancy, 34 (1.2%) patients had NTM infections. Mycobacterium avium-intracellulare complex (13 patients, 38%) was the most commonly isolated species, followed by M. abscessus (21%), M. fortuitum (18%), and M. kansasii (18%). Twenty-six patients had pulmonary NTM infection and eight patients had disseminated disease. Neutropenia was more frequently encountered among patients with disseminated NTM disease (p=0.007) at diagnosis than among patients with pulmonary disease only. Twenty-five (74%) patients received adequate initial antibiotic treatment. Five of the 34 patients died within 30 days after diagnosis. Cox regression multivariate analysis showed that chronic kidney disease (p=0.017) and neutropenia at diagnosis (p=0.032) were independent prognostic factors of NTM infection in patients with hematological malignancy. Patients with NTM infection had higher absolute neutrophil counts at diagnosis (p=0.003) and a higher 30-day mortality rate (15% vs. 2%, p=0.025) than TB patients. Hematological patients with chronic kidney disease and febrile neutropenia who developed NTM infection had significant worse prognosis than patients with TB infection. ? Springer-Verlag 2011. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/479963 | ISSN: | 0934-9723 | DOI: | 10.1007/s10096-011-1407-7 | SDG/關鍵字: | amikacin; ciprofloxacin; clarithromycin; ethambutol; imipenem; isoniazid; pyrazinamide; quinoline derived antiinfective agent; rifabutin; rifampicin; antiinfective agent; adult; aged; article; atypical mycobacteriosis; chronic kidney disease; clinical article; controlled study; female; hematologic malignancy; human; lung infection; male; medical record review; miliary tuberculosis; mortality; Mycobacterium abscessus; Mycobacterium avium; Mycobacterium fortuitum; Mycobacterium kansasii; Mycobacterium marinum; Mycobacterium tuberculosis; neutropenia; nonhuman; outcome assessment; priority journal; prognosis; retrospective study; adolescent; atypical mycobacteriosis; atypical Mycobacterium; bacteremia; bacterial pneumonia; blood disease; classification; isolation and purification; microbiology; middle aged; neutropenia; pathology; survival; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacteremia; Female; Hematologic Neoplasms; Humans; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Neutropenia; Nontuberculous Mycobacteria; Pneumonia, Bacterial; Retrospective Studies; Survival Analysis; Young Adult |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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