Bacterial Infection in Patients with Transfusion-Dependent β-Thalassemia in Central Taiwan

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。

關鍵字

β型海洋性貧血症；經常輸血治療；細菌感染

並列摘要

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).

並列關鍵字

bacterial infection ； β-thalassemia ； transfusion

國際替代計量

Bacterial Infection in Patients with Transfusion-Dependent β-Thalassemia in Central Taiwan

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