PDF(Pubmed)
Abstract：
Infections pose a significant threat to morbidity and mortality during treatments for pediatric cancer patients. Efforts to minimize the risk of infection necessitate preventive measures encompassing both environmental and host-focused strategies. While a substantial number of infections in oncologic patients originate from microorganisms within their native microbiological environment, such as the oral cavity, intestines, and skin, the concrete risk of bloodstream infections linked to the consumption of contaminated food and beverages in the community cannot be overlooked. Ensuring food quality and hygiene is essential to mitigating the impact of foodborne illnesses on vulnerable patients. The neutropenic diet (ND) has been proposed to minimize the risk of sepsis during neutropenic periods. The ND aims to minimize bacterial entry into the gut and bacterial translocation. However, a standardized definition for ND and consensus guidelines for specific food exclusions are lacking. Most centers adopt ND during neutropenic phases, but challenges in achieving caloric intake are common. The ND has not demonstrated any associated benefits and does not ensure improved overall survival. Consequently, providing unified and standardized food safety instructions is imperative for pediatric patients undergoing hematopoietic cell transplantation (HCT). Despite the lack of evidence, ND is still widely administered to both pediatric and adult patients as a precautionary measure. This narrative review focuses on the impact of foodborne infections in pediatric cancer patients and the role of the ND in comparison to food safety practices in patients undergoing chemotherapy or HCT. Prioritizing education regarding proper food storage, preparation, and cooking techniques proves more advantageous than merely focusing on dietary limitations. The absence of standardized guidelines underscores the necessity for further research in this field.
摘要：
感染对儿科癌症患者治疗期间的发病率和死亡率构成重大威胁。为了尽量减少感染风险，必须采取包括环境和以宿主为重点的战略在内的预防措施。虽然肿瘤患者的大量感染源于其天然微生物环境中的微生物，比如口腔，肠子,和皮肤，与社区食用受污染食品和饮料有关的血液感染的具体风险不容忽视。确保食品质量和卫生对于减轻食源性疾病对弱势患者的影响至关重要。中性粒细胞减少性饮食（ND）已被提议将中性粒细胞减少期脓毒症的风险降至最低。ND旨在最大程度地减少细菌进入肠道和细菌移位。然而,缺乏针对ND的标准化定义和针对特定食品排除的共识指南。大多数中心在中性粒细胞减少期采用ND，但是实现热量摄入的挑战是常见的。ND没有表现出任何相关的益处，也不能确保总体生存率的提高。因此,对于接受造血细胞移植（HCT）的儿科患者，提供统一和标准化的食品安全说明势在必行。尽管缺乏证据,作为预防措施，ND仍广泛用于儿科和成人患者。这篇叙述性综述侧重于儿童癌症患者食源性感染的影响，以及ND与接受化疗或HCT患者的食品安全实践相比的作用。优先考虑适当储存食物的教育，准备,和烹饪技术被证明比仅仅关注饮食限制更有利。缺乏标准化指南强调了在这一领域进一步研究的必要性。
