加用亚胺培南/西司他丁预防方案对造血干细胞移植后早期感染的影响

Prophylaxis effect on early infectious complications following hematopoietic stem cells transplantation with antibiotic regimen augmented by imipenem/cilastatin

目的 了解在常规抗生素预防方案基础上加用亚胺培南 /西司他丁对造血干细胞移植早期感染发生的影响。方法 观察中山大学附属第二医院儿科造血干细胞移植中心 1998年 1月至 2001年 12月收治的 12例亚胺培南 /西司他丁预防组和 12例常规抗生素预防对照组的造血干细胞移植患儿移植早期感染发生的种类、病原体培养结果、感染发生和控制时白细胞数变化以及移植早期感染发生的天数和持续时间等资料,采用t检验和非参数检验进行统计分析。结果 所有 24例患儿首次感染均发生在中性粒细胞绝对计数 >0 5×109 /L之前;移植早期感染最常见为呼吸道感染和口腔炎、胃肠炎等消化道黏膜炎。加用亚胺培南 /西司他丁组首次感染发生的时间[ (8 75±4 61)d]较常规对照组[ (4 67±2 31)d]明显推迟;亚胺培南 /西司他丁预防组患儿外周血白细胞均数(0 55×109 /L)感染发生时显著高于对照组(0 09×109 ),差异有显著性。结论 移植前在常规抗生素预防方案基础上加用亚胺培南 /西司他丁可以推迟移植早期感染的发生时间,对移植早期感染的预防有一定的效果。

Objective To study the prophylaxis effect on early infectious complications following hematopoietic stem cells transplantation(HSCT)with antibiotic regimen augmented by imipenem/cilastatin.Methods Retrospectively analyze the data of the variety of early infectious complications,microbiological culture result,absolute neutrophil count(ANC)at the begining and end of the infection,the incidence and duration of early infectious complications in the imipenem/cilastatin prophylaxis group and antibiotic prophylaxis group.The data was statistically analyzed by t-test and non-parametric statistical test.Results All of the 24 children from the two groups developed early infectious complications by the time ANC>0.5×109/L.The most common infection site was digestive tract (oral and gastrosintestinal mucositis) and then respiratory tract.Imipenem/cilastatin prophylaxis could postpone the early infections significantly(days:8.75±4.61 vs 4.67±2.31).Antibiotic prophylaxis(including imipenem/cilastatin).ANC of imipenem/cilastatin prophylaxis group was also significantly higher than the control (0.55×10 9 vs 0.09×10 9,P<0.05).Conclusion Imipenem/cilastatin prophylaxis regimen can postpone the early infection incidence and may has effect on the early infectious complications prevention.