COLONIZATION RESISTANCE - ACUTE LEUKEMIA

定植抵抗 - 急性白血病

• 批准号: 3186544
• 负责人: JAI H JOSHI
• 金额: $ 7.23万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 1986
• 资助国家: 美国
• 起止时间: 1986-04-01 至 1988-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3186544
• 关键词: Enterobacteriaceae; Pseudomonas aeruginosa; amphotericin B; anaerobic bacteria; antibacterial agents; combination chemotherapy; communicable disease control; dosage; feces analysis; gram negative bacteria; granulocytopenia; human subject; microorganism classification; microorganism immunology; neoplasm /cancer chemotherapy; oral bacteria; trimethoprim

Colonization with potentially pathogenic organisms and infections continue to be seen despite the use of selective decontaminating (anaerobic preserving) oral prophylactic antibiotics during periods of profound, persistent granulocytopenia in patients with acute leukemia undergoing induction chemotherapy. This may be related to the use of systemic antibiotics which suppress alimentary canal anaerobes which are believed to be responsible, in large measure, for decreasing/resisting colonization. The aim of this project is to determine if consistent alimentary canal anaerobic flora preservation with concurrent suppression of aerobic potential pathogens will reduce colonization with new, potentially pathogenic microorganisms in acute leukemia patients undergoing induction chemotherapy. Patients will receive selective decontaminating but anaerobic sparing prophylactic oral antibiotics, being randomly assigned to amphotericin B plus either trimethoprimsulfamethoxazole or norfloxacin. In the setting of fever and granulocytopenia, however, these patients will be randomized to receive therapeutic antibiotic(s) that eithr continue to preserve anaerobes (ceftazidime +/- tobramycin) or have anti-anaerobic activity (ceftazidime + piperacillin). The effect of prohylactic and systemic antibiotic(s) on alimentary canal flora will be confirmed by quantitative stool cultures and determinations of Beta-aspartylglycine in faecal specimens in ten patients in each of the groups receiving either mode of prophylaxis and either form of systemic therapy. Microbiological surveillence with twice weekly semiquantitative gingival and rectal cultures of all patients throughout the study period will permit determinations of colonization. A comparison of new organism acquisition, particularly gram-negative and/or antibiotic resistant potential pathogens and fungi in patient groups in whom alimentary canal anaerobes were or were not consistently preserved throughout the period of granulocytopenia, will test the concept that alimentary canal anaerobic flora preservation reduces colonization, thereby imparting colonization resistance.

潜在的致病生物和感染的定殖继续 尽管使用了选择性去氨基化（厌氧），但仍可以看到 保存）口服预防性抗生素， 急性白血病患者的持续性粒细胞减少症 诱导化疗。 这可能与系统性使用有关 抗生素会抑制消化道厌氧菌，据信 在很大程度上负责减少/抵抗定殖。 该项目的目的是确定是否一致的消化道 厌氧菌群保存和同时抑制有氧 潜在的病原体将通过新的，潜在的 急性白血病患者的致病微生物 化学疗法。 患者将获得选择性的去氨基化，但厌氧保留 预防性口服抗生素，随机分配给两性霉素B 再加上甲氧苄啶甲氧唑磺胺甲氧唑或诺福沙星。 在 然而，发烧和粒细胞减少症，这些患者将被随机分为 接受EITHR继续保存厌氧菌的治疗抗生素 （头孢氮蛋白+/- tobramycin）或具有抗动脉粥样硬化活性（头孢兹兹氏菌 + 哌拉西林）。 亲伴随和全身性抗生素的作用对 消化道菌群将通过定量的粪便培养物来确认 在十名患者的粪便标本中测定β-冬氨酰基甘氨酸 在每个接受预防模式和两种形式的组中 全身疗法。 微生物监测，每周两次 所有患者的半定量牙龈和直肠培养 研究期将允许确定定殖。 新生物体获取的比较，尤其是革兰氏阴性和/或 患者组的抗生素耐药性病原体和真菌 消化的运河厌氧菌是或不始终保存的 在整个粒细胞减少期间，将测试以下概念 养殖运河厌氧菌植物保护可降低定殖，从而降低殖民化 赋予定殖抗性。

项目成果

Double beta-lactam regimen compared to an aminoglycoside/beta-lactam regimen as empiric antibiotic therapy for febrile granulocytopenic cancer patients.

双 β-内酰胺方案与氨基糖苷/β-内酰胺方案作为经验性抗生素治疗发热性粒细胞减少性癌症患者的比较。

• DOI: 10.1007/bf00366445
• 发表时间: 1993
• 期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
• 作者: Joshi,JH;Newman,KA;Brown,BW;Finley,RS;Ruxer,RL;Moody,MA;Schimpff,SC
• 通讯作者: Schimpff,SC