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Recently, Professor Wang Chun from Shanghai Zhaxin Hospital gave us a detailed interpretation and experience sharing on the prevention and control of pulmonary infections in patients with blood diseases.
The editor is organized as follows for the reference of readers.
Patients with blood diseases have low immunity and are often high-risk groups of various infections, especially lung infections are very common.
What is the incidence, diagnosis and treatment of pulmonary infectious diseases in the Department of Hematology? The weakened immune function of patients with blood diseases is mainly caused by two reasons.
The first is the problem of the disease itself, such as neutrophil deficiency and poor lymphocyte function.
Another reason is that high-dose radiotherapy and chemotherapy have led to poor immune function in patients.
The combination of the two causes leads to neutropenia, gastrointestinal mucosal damage, and loss of physical barriers, which significantly increases the incidence of infections, especially fatal infections.
Therefore, as a special group, patients with blood diseases need special treatment in the anti-infective treatment group.
Pulmonary infection is the most common type of infection, accounting for about 40% of all infections.
Others include gastrointestinal infections, skin and soft tissue infections, and bloodstream infections.
In recent years, with the improvement of infection diagnosis and treatment capabilities and the use of new antibiotics, we have made great progress in the control and management of lung infections, and most patients including bacterial infections and fungal infections can be cured .
However, some pulmonary infections in the department of hematology are also more complicated.
They are mixed infections.
Often, bacterial infections, fungal infections, and viral infections are mixed together to cause disease.
Diagnosis and treatment require comprehensive considerations in many aspects and selection of wide-covered treatments to ensure Effective control of infection.Anti-infection is a very critical link in the process of hematopoietic stem cell transplantation.
What are the difficulties in clinical infection prevention and control? Hematopoietic stem cell transplantation is equivalent to the strongest chemotherapy and the strongest immunosuppression in the treatment of hematological diseases.
Patients receiving hematopoietic stem cell transplantation are the people with the lowest immunity.
Therefore, it is also the most difficult to prevent and control infections for this group of people.
As a transplant doctor, if you do not have a good grasp of infection prevention and control, the mortality rate of patients will increase significantly.
Therefore, the first step in infection prevention and control is prevention.
Before neutrophils are deficient and the mucosal barrier is damaged, the pathogenic microorganisms that colonize the body must be eliminated, including the removal of colonizing bacteria and colonizing fungi.
In this way, when neutrophils are deficient and the mucosal barrier is damaged, no pathogenic microorganisms are colonized in the body, which will greatly reduce the chance of infection.
Second, you need to know where the infection occurred.
In general clinical practice, the probability of a positive blood culture is very low, so it is necessary to make a diagnosis of infection and clarify the site of infection.
Except for lung infections, most of the infections mainly come from the gastrointestinal tract, mainly Gram-negative bacteria.
The choice of drugs is mainly to cover Gram-negative bacteria.
If lung infections are combined, cover Gram-negative bacteria is added.
Antibacterial drugs and antifungal drugs.
Only in this way can patients survive the infection safely and persist until the recovery of hematopoietic function and immune function.
For patients with infection complications after transplantation, especially elderly patients with poor drug resistance, how should the treatment efficiency be improved and the prognosis improved? The biggest obstacle to transplantation in elderly patients is poor organ function in elderly patients, which is different from younger ones.
Elderly patients have poor tolerance to various complications such as toxic reactions of radiotherapy and chemotherapy, immune damage, and infections.
Therefore, the need Special treatment for elderly patients.
First of all, the dose of chemotherapy for elderly patients should be reduced, and a pretreatment program that reduces toxicity or intensity can be used to effectively remove lymphocytes in the patient's body.
After the transplantation of the donor’s stem cells, the rejection of the donor’s immune cells is used to eliminate tumor cells in elderly patients, which can reduce the mortality rate in the early stages of transplantation.
When transplantation is successful, the application of immunosuppressive agents will result in a low immune function, and various types of infections will occur, including bacterial infections, fungal infections, and viral infections.
These patients' lung infections are often mixed infections, relying on experience Sex therapy is not enough.
Professor Wang Chun said that under the guidance of respiratory doctors, tests such as alveolar lavage and pathogen metagenomic second-generation sequencing (mNGS) have increased the diagnosis rate of infectious pathogens to more than 85%, and the success rate of treatment has also increased significantly.
The same is true for other complications.
For elderly patients, attention should be paid to organ protection and supportive treatment.
Only on this basis can hematopoietic stem cell transplantation be properly performed for elderly patients and the prognosis can be improved.
Through the detailed interpretation of Professor Wang Chun, we learned that hematological diseases, especially lung infectious complications of patients after transplantation, are very common and often complicated.
The prevention and control of clinical infections are difficult and require sufficient attention from doctors.
In the era of precision diagnosis and treatment, the diagnosis and treatment of infections also need to be combined with new technical means to provide more accurate diagnosis and treatment for patients.
Poke "read the original text" and we will make progress together
The editor is organized as follows for the reference of readers.
Patients with blood diseases have low immunity and are often high-risk groups of various infections, especially lung infections are very common.
What is the incidence, diagnosis and treatment of pulmonary infectious diseases in the Department of Hematology? The weakened immune function of patients with blood diseases is mainly caused by two reasons.
The first is the problem of the disease itself, such as neutrophil deficiency and poor lymphocyte function.
Another reason is that high-dose radiotherapy and chemotherapy have led to poor immune function in patients.
The combination of the two causes leads to neutropenia, gastrointestinal mucosal damage, and loss of physical barriers, which significantly increases the incidence of infections, especially fatal infections.
Therefore, as a special group, patients with blood diseases need special treatment in the anti-infective treatment group.
Pulmonary infection is the most common type of infection, accounting for about 40% of all infections.
Others include gastrointestinal infections, skin and soft tissue infections, and bloodstream infections.
In recent years, with the improvement of infection diagnosis and treatment capabilities and the use of new antibiotics, we have made great progress in the control and management of lung infections, and most patients including bacterial infections and fungal infections can be cured .
However, some pulmonary infections in the department of hematology are also more complicated.
They are mixed infections.
Often, bacterial infections, fungal infections, and viral infections are mixed together to cause disease.
Diagnosis and treatment require comprehensive considerations in many aspects and selection of wide-covered treatments to ensure Effective control of infection.Anti-infection is a very critical link in the process of hematopoietic stem cell transplantation.
What are the difficulties in clinical infection prevention and control? Hematopoietic stem cell transplantation is equivalent to the strongest chemotherapy and the strongest immunosuppression in the treatment of hematological diseases.
Patients receiving hematopoietic stem cell transplantation are the people with the lowest immunity.
Therefore, it is also the most difficult to prevent and control infections for this group of people.
As a transplant doctor, if you do not have a good grasp of infection prevention and control, the mortality rate of patients will increase significantly.
Therefore, the first step in infection prevention and control is prevention.
Before neutrophils are deficient and the mucosal barrier is damaged, the pathogenic microorganisms that colonize the body must be eliminated, including the removal of colonizing bacteria and colonizing fungi.
In this way, when neutrophils are deficient and the mucosal barrier is damaged, no pathogenic microorganisms are colonized in the body, which will greatly reduce the chance of infection.
Second, you need to know where the infection occurred.
In general clinical practice, the probability of a positive blood culture is very low, so it is necessary to make a diagnosis of infection and clarify the site of infection.
Except for lung infections, most of the infections mainly come from the gastrointestinal tract, mainly Gram-negative bacteria.
The choice of drugs is mainly to cover Gram-negative bacteria.
If lung infections are combined, cover Gram-negative bacteria is added.
Antibacterial drugs and antifungal drugs.
Only in this way can patients survive the infection safely and persist until the recovery of hematopoietic function and immune function.
For patients with infection complications after transplantation, especially elderly patients with poor drug resistance, how should the treatment efficiency be improved and the prognosis improved? The biggest obstacle to transplantation in elderly patients is poor organ function in elderly patients, which is different from younger ones.
Elderly patients have poor tolerance to various complications such as toxic reactions of radiotherapy and chemotherapy, immune damage, and infections.
Therefore, the need Special treatment for elderly patients.
First of all, the dose of chemotherapy for elderly patients should be reduced, and a pretreatment program that reduces toxicity or intensity can be used to effectively remove lymphocytes in the patient's body.
After the transplantation of the donor’s stem cells, the rejection of the donor’s immune cells is used to eliminate tumor cells in elderly patients, which can reduce the mortality rate in the early stages of transplantation.
When transplantation is successful, the application of immunosuppressive agents will result in a low immune function, and various types of infections will occur, including bacterial infections, fungal infections, and viral infections.
These patients' lung infections are often mixed infections, relying on experience Sex therapy is not enough.
Professor Wang Chun said that under the guidance of respiratory doctors, tests such as alveolar lavage and pathogen metagenomic second-generation sequencing (mNGS) have increased the diagnosis rate of infectious pathogens to more than 85%, and the success rate of treatment has also increased significantly.
The same is true for other complications.
For elderly patients, attention should be paid to organ protection and supportive treatment.
Only on this basis can hematopoietic stem cell transplantation be properly performed for elderly patients and the prognosis can be improved.
Through the detailed interpretation of Professor Wang Chun, we learned that hematological diseases, especially lung infectious complications of patients after transplantation, are very common and often complicated.
The prevention and control of clinical infections are difficult and require sufficient attention from doctors.
In the era of precision diagnosis and treatment, the diagnosis and treatment of infections also need to be combined with new technical means to provide more accurate diagnosis and treatment for patients.
Poke "read the original text" and we will make progress together
