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題名 | Bacterial Infection in Patients with Transfusion-Dependent β-Thalassemia in Central Taiwan=臺灣中部地區需要經常接受輸血治療的β型海洋性貧血症患者之細菌感染 |
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作 者 | 彭慶添; 蔡長海; 王任賢; 邱昌芳; 周寬基; | 書刊名 | 臺灣兒科醫學會雜誌 |
卷期 | 41:6 民89.11-12 |
頁次 | 頁318-321+351 |
分類號 | 415.513 |
關鍵詞 | β型海洋性貧血症; 經常輸血治療; 細菌感染; Bacterial infection; β-thalassemia; Transfusion; |
語文 | 英文(English) |
中文摘要 | 本臨床研究以評估三十九位經常接受輸血治療之β型海洋性貧血症患者,所發生的感染細菌種別、感染類別以及他們發生感染的危險因子爲目的。這群病人當中,有十三位曾發生了22次的細菌感染,其中八人發生了16次的菌血(72.7%)。這十三位病人的病情分別是,三例腦膜炎,兩例肝蓄膿,三例軟組織發炎,一例尿道發炎,一例肺炎,五例是非菌血的不明原因高燒。這22次感染所檢測出來的細菌絕大多數是格蘭氏陰性菌。本臨床研究的結果主要是發現病人以靜脉插管者的細菌感染率最高(1.7次/人,P=0.0069),其次則是鐵蛋白濃度超過2,000ng/mL者(1.18次/人,P=0.028),然後是脾臟切除者(1.08次/人,P=0.025)。這些病人的年感染率平均是0.45次/100人-年,確實比本院一般兒科病人的平均年感染率(0.023次/100人-年)高約二十倍。 |
英文摘要 | The microorganisms, outcome of infections and the risk factors were evaluated in 39 patients with β-thalassemia who received frequent blood transfusions. Among these patients, thirteen developed 22 episodes of infections, and bacteremia accounted for 72.7% (16/22) of all infections. Three patients developed meningitis, two patients had liver abscesses, three patients had soft tissue infections, one patient had a urinary tract infection and one patient had lobar pneumonia. Interestingly, a large proportion of the patients were infected by Gram-negative bacteria. Patients who were implanted with intravascular catheters were most susceptible to bacterial infection (1.70 episodes/patient) (P=0.0069). So were patients with ferritin levels over 2,000ng/mL (1.18 episodes/patient) (P=0.028). The frequency of bacterial infections in patients with splenectomies (1.08 episode/patient) was also significantly higher than that of the average patient (P=0.025). In conclusion, three major risk factors for bacterial infection were identified in this group of patients: intravascular catheterization, high serum ferritin levels (>2,000ng/mL) and splenectomy. The infection rate of these patients (0.45 episode/100 patient-year) is about 20-fold higher than that of general pediatric patients (0.023 episode/100 patientyear). |
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