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菌血症肺炎是伴有粒细胞缺乏的癌症患者重要的病死原因,Carratala等就伴有粒细胞缺乏的癌症患者合并菌血症肺炎的病因、经验性抗生素治疗和预后进行了研究.研究期间凡接受细胞毒化疗7d以上有可能发生粒细胞缺乏的患者预防性口服诺氟沙星400mg,每日2次,绝大部分发热患者先给予头孢他啶和阿米卡星,然后再根据细菌学资料调整抗生素治疗.菌血症肺炎的定义为出现急性呼吸系统病变,伴有胸片浸润阴影和血培养阳性.粒细胞<100×10~(-9)L为粒细胞缺乏.若头孢他啶对细菌的MIC>2mg/L为经验性抗生素治疗无效.10年研究期间伴有粒细胞缺乏的癌症患者共检出408例次菌血症,菌血症起源于肺炎占9.8%,即39例40例次.其中男26例,女13例,平均年龄56岁(16～84岁).血液系恶性肿瘤26例,实体瘤13例.早期
Bacteremia pneumonia is an important cause of death in cancer patients with agranulocytosis. Carratala et al. studied the etiology, empiric antibiotic treatment, and prognosis of patients with neutropenia associated with bacteremia pneumonia. Patients with neutropenia who have been treated with cytotoxic chemotherapy for more than 7 days are prophylactically administered norfloxacin 400 mg twice a day. The majority of fever patients are given ceftazidime and amikacin, and then antibiotics are adjusted based on bacteriological data. Treatment. Bacteremia pneumonia is defined as the presence of acute respiratory disease, with chest X-ray infiltration shadow and blood culture positive. Granulocyte <100 x 10 ~ (-9) L is agranulocytosis. If ceftazidime against bacteria MIC> 2mg/L was ineffective for empiric antibiotic therapy. A total of 408 cases of bacteremia were detected in cancer patients with neutropenia during the 10-year study period. Bacteremia originated in 9.8% of pneumonia, that is, 39 cases were 40 cases. There were 26 males and 13 females with an average age of 56 years (16-84 years old). There were 26 cases of hematological malignant tumors and 13 cases of solid tumors.