Infecciones en el paciente inmunocomprometido (I). Paciente con tratamiento esteroideo y otros inmunosupresores. Paciente neutropénico

  1. Falcón Abad, R. 1
  2. Íñigo Pestaña, M. 1
  3. Pérez García, A. 1
  1. 1 Servicio de Microbiología Clínica y Parasitología, Clínica Universidad de Navarra, Madrid, España
Zeitschrift:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Datum der Publikation: 2022

Titel der Ausgabe: Enfermedades infecciosas (VIII)

Serie: 13

Nummer: 56

Seiten: 3277-3287

Art: Artikel

DIALNET GOOGLE SCHOLAR

Andere Publikationen in: Medicine: Programa de Formación Médica Continuada Acreditado

Zusammenfassung

Infections represent one of the main causes of morbidity and mortality in immunosuppressed patients. Prolonged, profound neutropenia is one of the most important risk factors of sepsis and associated mortality. Fever may be the only clinical symptom these patients manifest; it is considered a medical emergency. Glucocorticoids act on various levels of inflammatory and immunological processes, facilitating opportunistic infections. Biological therapies are becoming more and more varied, with effects that remain to be studied. Therefore, the indications must be updated and reviewed periodically. A rapid diagnosis that guides effective treatment is crucial for avoiding infectious complications in these patients. The emergence of multidrug-resistant microorganisms is a challenge to the treatment approach to patients with febrile neutropenia.

Bibliographische Referenzen

  • Fauci AS, Dale DC, Balow JE. Glucocorticosteroid therapy: mechanisms of action and clinical considerations. Ann Intern Med. 1976;84(3):304-15.
  • Martínez AR, Pascual IP, Rubio EM. Infecciones en el paciente inmunocomprometido (I). Paciente neutropénico. Tratamiento esteroideo y otros inmunosupresores. Medicine. 2018;12(55):3237-44.
  • Winthrop KL, Mariette X, Silva JT, Benamu E, Calabrese LH, Dumusc A. ESCMID Study Group for Infections in Compro- mised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an infectious diseases perspective (Soluble immune effector molecules [II]: agents targeting interleukins, immunoglobulins and complement factors). Clin Microbiol Infect. 2018;24:S21-40.
  • Taplitz RA, Kennedy EB, Bow EJ, Crews J, Gleason C, Hawley DK. Antimicrobial prophylaxis for adult patients with cancer- related immunosuppression: ASCO and IDSA clinical practice guideline update. J Clin Oncol. 2018;36(30):3043-54.
  • Morales IE, Villalobos MS, Jara CS. Protocolo terapéutico de la neutropenia. Medicine. 2020;13(20):1163-6.
  • White L, Ybarra M. Neutropenic fever. Hematol Oncol Clin North Am. 2017;31(6):981-93.
  • Gudiol C, Aguilar Guisado M, Azanza JR, Candel FJ, Cantón R, Carratalà J. Executive summary of the consensus document of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Network for Research in Infectious Diseases (REIPI) and the Spanish Society of Haematology and Haemotherapy (SEHH) on the management of febrile neutropenia in patients with hematological malignancies. Enferm Infecc Microbiol clin (Engl). 2020;38(4):174-81.
  • Cantwell L, Perkins J. Infectious disease emergencies in oncology patients. Emerg Med Clin North Am. 2018;36(4):795-810.
  • Seo SK, Liu C, Dadwal SS. Infectious disease complications in patients with cancer. Crit Care Clin. 2021;37(1):69-84.
  • Bow EJ. Infection in neutropenic patients with cancer. Crit Care Clin. 2013;29(3):411-41.
  • Martínez JAH. Protocolo diagnóstico del paciente inmunosuprimido sin infección por el VIH y fiebre. Medicine. 2014; 11(58):3452-6
  • McGrath B, Broadhurst M, Roman C. Infectious disease considerations in immunocompromised patients. JAAPA. 2020;33(9):16-25.
  • Pizzo PA. Management of patients with fever and neutropenia through the arc of time: A narrative review: A narrative review. Ann Intern Med. 2019;170(6):389-97.
  • Dropulic LK, Lederman HM. Overview of infections in the immunocompromised host. En: Diagnostic microbiology of the immu- nocompromised host. Washington, DC: ASM Press; 2016. p. 1-50.
  • Pizzo PA. From the Immunocompromised Host Society: the design, analysis, and reporting of clinical trials on the empirical antibiotic management of the neutropenic patient: report of a consensus panel. J Infec Dis. 1990;161(3):397-401.
  • Lyman GH, Abella E, Pettengell R. Risk factors for febrile neutropenia among patients with cancer receiving chemotherapy: A systematic review. Crit Rev Oncol Hematol. 2014;90(3):190-9.
  • Heinz WJ, Buchheidt D, Christopeit M, von Lilienfeld Toal M, Cornely OA, Einsele H. Diagnosis and empirical treatment of fever of unknown origin (FUO) in adult neutropenic patients: guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Hematol. 2017;96(11):1775-92.
  • Bodey GP. Unusual presentations of infection in neutropenic patients. Int J Antimicrob Agents. 2000;16(2):93-5.
  • Taplitz RA, Kennedy EB, Bow EJ, Crews J, Gleason C, Hawley DK. Outpatient management of fever and neutropenia in adults treated for malignancy: American society of clinical oncology and Infectious Diseases Society of America clinical practice guideline update. J Clin Oncol. 2018;36(14):1443-53.
  • Chen K, Wang Q, Pleasants RA, Ge L, Liu W, Peng K. Empiric treatment against invasive fungal diseases in febrile neutropenic patients: a systematic review and network meta-analysis. BMC Infect Dis. 2017;17(1):1-12.
  • Hansen B-A, Wendelbo Ø, Bruserud Ø, Hemsing AL, Mosevoll KA, Reikvam H. Febrile neutropenia in acute leukemia. Epidemiology, etiology, pathophysiology and treatment. Mediterr J Hematol Infect Dis. 2020;12(1):e2020009.
  • Lehrnbecher T, Robinson P, Fisher B, Alexander S, Ammann RA, Beauchemin M. Guideline for the management of fever and neu- tropenia in children with cancer and hematopoietic stem-cell transplantation recipients: 2017 update. J Clin Oncol. 2017;35(18):2082-94.
  • Lehrnbecher T. Treatment of fever in neutropenia in pediatric oncology patients. Curr Opin Pediatr. 2019;31(1):35-40.
  • Al Omar S, Moumani D, Rihani R. Antibacterial prophylaxis in pediatric patients with leukemia. Saudi Pharm J. 2018;26(6):810-6.
  • Sun Y, Huskey RL, Tang L, Inaba H, Gaur AH, Ribeiro R. Adverse effects of intravenous vancomycin-based prophylaxis during therapy for pediatric acute myeloid leukemia. Antimicrob Agents Chemother. 2018;62(3):e01838-17.
  • Flores IQ, Ershler W. Managing neutropenia in older patients with cancer receiving chemotherapy in a community setting. Clin J Oncol Nurs. 2010;14(1):81-6.
  • Shallis RM, Zeidan AM. Management of the older patient with myelodysplastic syndrome. Drugs Aging. 2021;38(9):751-67.
  • Al-Quteimat OM, Amer AM. The impact of the COVID-19 pandemic on cancer patients. Am J Clin Oncol. 2020;43(6):452-5.
Fuente de los datos: Dialnet