Schønheyder H C
Aalborg Sygehus, klinisk mikrobiologisk afdeling.
Ugeskr Laeger. 2000 May 15;162(20):2886-91.
A complete registration of bacteraemias has been undertaken in the County of Northern Jutland (population 493,000) since 1996, in the form of a bacteraemia register maintained by the Department of Clinical Microbiology, Aalborg Hospital, which serves the seven hospitals in the county. A follow-up is conducted on all patients with positive blood cultures. We registered 2,739 bacteraemias during 1996-1998. Eighty-nine percent of bacteraemias were monomicrobial and 11% polymicrobial. Among monomicrobial bacteraemias the predominant bacteria were Staphylococcus aureus (17%), Streptococcus pneumoniae (12%), Escherichia coli (31%), and other enterobacteria (14%). The source (focus) of infection was identified in 82% and the main foci were the urogenital tract (28%), the respiratory tract (14%), the digestive tract (13%), the hepato-biliary tract (8%), and intravascular devices (8%). The overall 30 day case fatality rate (CFR) was 21.5%. At first notification antibiotic therapy was appropriate in 54% of bacteraemias (CFR 14.8%), antibiotic therapy was inappropriate or missing in 38% (CFR 21.0%), active therapy had been withdrawn in 0.3%, in 5% the patient had died, and in 2% therapy had been completed or the patient had been discharged alive. The register has thus created a platform for research projects regarding risk factors, therapy and prognosis of bacteraemia.
自1996年以来,丹麦北日德兰郡(人口49.3万)对菌血症进行了全面登记,以奥尔堡医院临床微生物科维护的菌血症登记册的形式进行,该医院为该郡的七家医院提供服务。对所有血培养呈阳性的患者进行随访。我们在1996 - 1998年期间登记了2739例菌血症。89%的菌血症为单一微生物感染,11%为多种微生物感染。在单一微生物菌血症中,主要细菌为金黄色葡萄球菌(17%)、肺炎链球菌(12%)、大肠杆菌(31%)和其他肠杆菌(14%)。82%的感染源(病灶)得以确定,主要病灶为泌尿生殖道(28%)、呼吸道(14%)、消化道(13%)、肝胆道(8%)和血管内装置(8%)。总体30天病死率(CFR)为21.5%。首次报告时,54%的菌血症患者抗生素治疗恰当(CFR为14.8%),38%的患者抗生素治疗不当或未进行治疗(CFR为21.0%),0.3%的患者已停止积极治疗,5%的患者已死亡,2%的患者治疗已完成或已存活出院。因此,该登记册为开展关于菌血症危险因素、治疗和预后的研究项目创造了一个平台。