期刊文献+

成人血流感染预后相关因素分析 被引量:3

Prognostic factors for bloodstream infection in adults
原文传递
导出
摘要 目的了解所在医院成人血流感染后影响预后的相关因素。方法收集所在医院2002年1月至2003年12月检验科记录的血培养阳性病例131例,查阅其中91例成人患者的相关临床资料,从而了解本院血流感染病原菌种类,分析影响预后的相关因素。结果 91例中革兰阴性菌53例(58.2%),主要为大肠埃希菌、沙门菌属细菌和肺炎克雷白杆菌;革兰阳性菌28例(30.8%),主要为金黄色葡萄球菌和凝固酶阴性葡萄球菌;真菌8例(8.8%),多重病原菌2例(2.2%)。本组脓毒血症患者在院病死率30.8%,铜绿假单胞菌、金黄色葡萄球菌、嗜麦芽窄食单胞菌以及大肠埃希菌产超广谱β内酰胺酶菌株感染者死亡率高达50%以上。在院病死率与病情严重程度(OR=1.15)、初始抗生素经验性治疗不合适(OR=6.77)有关。结论本研究所在医院成人血流感染病原菌以革兰阴性菌为主,病情严重以及初始抗生素经验性治疗不合适使血流感染病死率增加。 Objective To investigate prognostic factors for bloodstream infection in adult patients. Methods Clinical data of 131 adult patients with positive blood cultures during January 2002 to December 2003 in the Hospital were collected and 91 cases of them were retrospectively analyzed to understand their pathogen species and prognostic factors for it. Results Blood samples from 91 patients were cultured positive, 53 cases (58.2%) with gram-negative bacteria mainly including Escherichia coli, Salmonella spp. and Klebsiella pneumoniae, 28 (30.8%) with gram-positive bacteria, mainly including Staphylococcus aureas and coagulase-negative Staphylococci, eight (8.8%) with fungi and two (2.2%) with multiple infections. Case fatality ratio in this group of patients with septicemia was 30.8% during their hospitalization, and that in those with Pseudomonas aeruginosa, Staphylococcus aureas, Stenotrophomonas maltophilia and E. coli with extended-spectrum beta-lactamase was over 50%. Case fatality ratio was associated with severity of sepsis (OR = 1.15) and inappropriately initial empirical treatment with antibiotics (OR = 6.77). Conclusions Pathogen causing bloodstream infection in adults were mainly gram-negative bacteria and severity of infection and inappropriate initial antibiotics treatment could increase their fatality.
出处 《中华全科医师杂志》 2006年第10期599-602,共4页 Chinese Journal of General Practitioners
关键词 感染 血传病原体 治疗结果 Infection Blood-borne pathogens Treatment outcome
  • 相关文献

参考文献7

  • 1Martin GS,Mannino DM,Eaton S,et al.The epidemiology of sepsis in the United States from 1979 through 2000.N Engl J Med,2003,348:1546-1554.
  • 2Ibrahim EH,Sherman G,Ward S,et al.The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting.Chest,2000,118:146-155.
  • 3Knaus WA,Draper EA,Wagner DP,et al.APACHE Ⅱ:a severity of disease classification system.Crit Care Med,1985,13:818 -829.
  • 4Vallés J,Rello J,Ochagavía A,et al.Community-acquired bloodstream infection in critically ill adult patients-impact of shock and inappropriate antibiotic therapy on survival.Chest,2003,123:1615-1624.
  • 5Gross PA,Barret TL,Dellinger EP,et al.Quality standard for the treatment of bacteremia.Clin Infect Dis,1994,18:428-430.
  • 6范洪伟,王爱霞,袁瑛,王辉,陈民钧.113例败血症的病原菌分析[J].中国抗感染化疗杂志,2003,3(2):99-102. 被引量:20
  • 7刘小平,徐安平,李建武,吴志成,李建新.细菌感染患者246例血培养阳性结果分析[J].中华检验医学杂志,2005,28(2):178-180. 被引量:50

二级参考文献12

共引文献68

同被引文献42

  • 1周红慧,周朝阳.密闭式气管内吸痰法在机械通气患者中的应用[J].当代护士(下旬刊),2010,17(8):160-162. 被引量:6
  • 2王鸣,彭炜,蔡敏,季刚.外科重症监护室645例脓毒症患者临床流行病学调查[J].中国危重病急救医学,2006,18(2):74-77. 被引量:31
  • 3Beekmann SE, Diekema DJ, Doern GV. Determining the clinical significance of coagulase-negative staphylococci isolated from blood cultures. Infect Control Hosp Epidemiol, 2005,26:559-566.
  • 4孙自镛,陈静,朱旭慧,张蓓,李丽,杜鹏超.1998年~2006年血流感染病原菌及其耐药性分析[J].临床内科杂志,2007,24(11):736-740. 被引量:10
  • 5李轶男,周立新,誉铁鸥,温伟标,方滨,毛克江,邹毅成,黎文研,黎昌.ICU重度脓毒症患者死亡危险因素分析[J].实用医学杂志,2007,23(24):3875-3877. 被引量:18
  • 6Vincent JL, Rello J, Marshall J, et al. International study of the prevalence and outcomes of infection in intensive care units [ J ]. JAMA,2009,302 (21) : 2323-2329.
  • 7Angus DC, Linde-Zwirble WT, Lidieker J, et al. Epidemiology of severe sepsis in the United States : analysis of incidence, outcome, and associated costs of care [J ]. Crit Care Med,2001,29 (7): 1303-1310.
  • 8Lin JN, Lai CH, Chen YH, et al. Characteristics and outcomes of polymicrobial bloodstream infections in the emergency department : A matched case-control study [ J ]. Acad Emerg Med,2010,17 (10) : 1072-1079.
  • 9Koupetori M, Retsas T, Antonakos N, et al. Bloodstream infections and sepsis in Greece:over-time change of epidemiology and impact of de-escalation on final outcome [ J ]. BMC Infect Dis, 2014, 14 : 272.
  • 10Vincent JL, Sakr Y, Sprung CL, et al. Sepsis in European intensive care units : results of the SOAP study [ J ]. Crit Care Med,2006, 34 (2) : 344-353.

引证文献3

二级引证文献50

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部