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Leuk Lymphoma：达托霉素治疗万古霉素耐药的肠球菌血流感染：风险因素和结局

2017-08-14 吴刚 环球医学

达托霉素肠球菌血流感染
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达托霉素常用作血液系统恶性肿瘤患者万古霉素耐药的肠球菌（VRE）血流感染（BSI）的治疗选择，但是越来越多的研究报道了达托霉素不敏感的VRE。2017年12月，发表在《Leuk Lymphoma》的一项研究调查了血液系统恶性肿瘤患者中，达托霉素不敏感的VRE血流感染的风险因素和结局。



达托霉素常用作血液系统恶性肿瘤患者万古霉素耐药的肠球菌（VRE）血流感染（BSI）的治疗选择，但是越来越多的研究报道了达托霉素不敏感的VRE。2017年12月，发表在《Leuk Lymphoma》的一项研究调查了血液系统恶性肿瘤患者中，达托霉素不敏感的VRE血流感染的风险因素和结局。

研究人员回顾了血液系统恶性肿瘤患者中，达托霉素不敏感的VRE BSI的经历。研究人员比较了20例达托霉素不敏感的VRE BSI（病例患者）与40例达托霉素敏感的VRE BSI配对对照患者的风险因素和结局。

结果显示，病例患者具有更多的并发症（6/20 vs 2/40，P=0.013），两组全因死亡率相似。多变量分析显示，仅有90天内既往达托霉素暴露与达托霉素不敏感的VRE BSI显着相关（比值比，26.71；P＜0.0001）。25%的病例患者中，VRE分离株的初始最小抑菌浓度（MIC）为4μg/mL的所有患者在治疗期间都出现了不敏感，这对较高剂量的达托霉素是否可用于血液系统恶性肿瘤患者VRE BSI的治疗提出了质疑。

原始出处：

Herc ES， Kauffman CA， Marini BL， et al. Daptomycin nonsusceptible vancomycin resistant Enterococcus bloodstream infections in patients with hematological malignancies： risk factors and outcomes. Leuk Lymphoma. 2017 Dec；58(12)：2852-2858. doi： 10.1080/10428194.2017.1312665. Epub 2017 Apr 12.

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    2017-10-01 ms5187542471278033

    #lymphoma#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1689291, encodeId=be061689291f9, content=<a href='/topic/show?id=1ddd11158fb' target=_blank style='color:#2F92EE;'>#lymphoma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11158, encryptionId=1ddd11158fb, topicName=lymphoma)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=45ae28785510, createdName=ms5187542471278033, createdTime=Sun Oct 01 21:58:00 CST 2017, time=2017-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1491719, encodeId=c9371491e19e4, content=<a href='/topic/show?id=130a8158305' target=_blank style='color:#2F92EE;'>#肠球菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81583, encryptionId=130a8158305, topicName=肠球菌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3c98898784, createdName=psybestwish, createdTime=Wed Aug 16 08:58:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511865, encodeId=bfbf151186509, content=<a href='/topic/show?id=d88b891e376' target=_blank style='color:#2F92EE;'>#血流感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89173, encryptionId=d88b891e376, topicName=血流感染)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=83b410387887, createdName=ms6829001416292975, createdTime=Wed Aug 16 08:58:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233547, encodeId=f4f923354ea5, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Mon Aug 14 19:57:54 CST 2017, time=2017-08-14, status=1, ipAttribution=)]
    2017-08-16 psybestwish

    #肠球菌#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1689291, encodeId=be061689291f9, content=<a href='/topic/show?id=1ddd11158fb' target=_blank style='color:#2F92EE;'>#lymphoma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11158, encryptionId=1ddd11158fb, topicName=lymphoma)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=45ae28785510, createdName=ms5187542471278033, createdTime=Sun Oct 01 21:58:00 CST 2017, time=2017-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1491719, encodeId=c9371491e19e4, content=<a href='/topic/show?id=130a8158305' target=_blank style='color:#2F92EE;'>#肠球菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81583, encryptionId=130a8158305, topicName=肠球菌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3c98898784, createdName=psybestwish, createdTime=Wed Aug 16 08:58:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1511865, encodeId=bfbf151186509, content=<a href='/topic/show?id=d88b891e376' target=_blank style='color:#2F92EE;'>#血流感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89173, encryptionId=d88b891e376, topicName=血流感染)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=83b410387887, createdName=ms6829001416292975, createdTime=Wed Aug 16 08:58:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=233547, encodeId=f4f923354ea5, content=学习了受益匪浅。, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Mon Aug 14 19:57:54 CST 2017, time=2017-08-14, status=1, ipAttribution=)]
    2017-08-16 ms6829001416292975

    #血流感染#

    0

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    2017-08-14 131****1460

    学习了受益匪浅。

    0

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