利奈唑胺治疗血液系统肿瘤患儿革兰阳性球菌感染的疗效及安全性

Efficacy and safety of linezolid for severe infections from gram-positive bacteria in children with hematological cancer

目的本研究旨在分析利奈唑胺治疗血液系统肿瘤患儿革兰阳性球菌感染的疗效及安全性。方法前瞻性纳入2015-2016年本院诊断为血液系统肿瘤、合并革兰阳性菌严重感染的患儿,对患儿进行常规化疗并单用利奈唑胺进行抗感染治疗,分析其疗效及安全性。结果纳入的26名患儿中男性15名,女性11名,中位年龄3.5岁(6月~13岁),利奈唑胺平均使用时间13.5 d(6~31 d)。所有患儿未检出对利奈唑胺耐药,且均达到临床治愈,20名细菌培养阳性患儿均达到微生物清除,6名经临床确认的感染患儿感染症状完全消失,总的有效率为100%。主要不良反应包括血小板减少、贫血,无其他严重不良反应发生。总的不良反应发生率为30.8%(8/26)。结论利奈唑胺治疗血液系统肿瘤患儿革兰阳性球菌严重感染的有效率及安全性较高。

Objective To determine the efficacy and safety of linezolid for severe infections from gram-positive bacteria in children with hematological cancer. Methods Children with hematological cancer and severe infections from gram-positive bacteria were prospectively recruited between 2015 -- 2016 in our hospital. All patients were routinely treated with chemotherapy cycles with linezolid as monotherapy, and the efficacy and safety of linezolid were analyzed. Results Totally 26 children （15 males and 11 females） were recruited, the median age was 3.5 years （6 months -- 13 years）, while the mean duration of linezolid administration was 13.5 days （6 -- 31 days）. No linezolid-resistant case was detected. All patients were considered clinically cured after the end of the linezolid regimen （100% efficacy）. The main adverse events included thrombocytopenia and anemia, and no severe adverse events were recorded. The total adverse event rate was 30.8% （8/26）. Conclusion Linezolid is safe and effective therapy to treat severe infections from resistant gram-positive bacteria in children with hematological cancer, even at young ages.