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综合医院中的菌血症。对102例连续病例的前瞻性研究。

Bacteremia in a general hospital. A prospective study of 102 consecutive cases.

作者信息

Jepsen O B, Korner B

出版信息

Scand J Infect Dis. 1975;7(3):179-84. doi: 10.3109/inf.1975.7.issue-3.05.

Abstract

A prospective clinical-bacteriological study of 102 consecutive cases of confirmed bacteremia at a Copenhagen City general hospital was carried out during 5 months of 1973 with special concern given to focus of infection and acquisition of microorganisms. Valid positive cultures were obtained from 7.2 patients per 1000 admissions. 50 of the 102 bacteremias were by all probability acquired in the hospital, mainly due to transurethral manipulations or intravenous lines. Pneumonia and hepatobiliary infections accounted for most of the non-hospital acquired bacteremias. 26/102 patients died in relation to the bacteremia. Escherichia coli and Staphylococcus aureus caused more than half of the infections. Bacteremia caused by proteus, klebsiella, enterobacter species of staphylococci was in most cases nosocomial and carried the highest mortality, i.e. 40%, verus 15% when other organisms were responsible. It is concluded that nosocomial bacteremia is a frequent and life-endangering complication which is often preceded by certain diagnostic or therapeutic procedures, not invariably linked to severe underlying diseases. Consequently, attempts to reduce bacteremic episodes should include surveillance of ecological factors and certain hospital procedures.

摘要

1973年的5个月期间,在哥本哈根市一家综合医院对102例连续确诊的菌血症病例进行了前瞻性临床细菌学研究,特别关注感染源和微生物的获得情况。每1000例住院患者中有7.2例获得有效的阳性培养结果。102例菌血症病例中,有50例很可能是在医院获得的,主要是由于经尿道操作或静脉输液管所致。肺炎和肝胆感染占非医院获得性菌血症的大部分。102例患者中有26例死于菌血症。大肠杆菌和金黄色葡萄球菌导致了一半以上的感染。变形杆菌、克雷伯菌、肠杆菌属葡萄球菌引起的菌血症在大多数情况下是医院获得性的,死亡率最高,即40%,而由其他微生物引起的菌血症死亡率为15%。得出的结论是,医院获得性菌血症是一种常见且危及生命的并发症,常常在某些诊断或治疗程序之前发生,并非总是与严重的基础疾病相关。因此,减少菌血症发作的努力应包括对生态因素和某些医院程序的监测。

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