Thulstrup A M, Sørensen H T, Schønheyder H C, Møller J K, Tage-Jensen U
Danish Epidemiology Science Centre, Institute of Epidemiology and Social Medicine, University of Aarhus, Aarhus, Denmark.
Clin Infect Dis. 2000 Dec;31(6):1357-61. doi: 10.1086/317494. Epub 2000 Nov 29.
We examined the risk of bacteremia in patients with liver cirrhosis (compared with the risk for all Danish citizens >20 years of age who were living in North Jutland County, Denmark), as well as the type of bacteremia and the 30-day case-fatality rate. We used the Danish National Registry of Patients to identify 1339 patients with liver cirrhosis, and we used the North Jutland County Bacteremia Database to identify episodes of bacteremia. We observed 117 cases of bacteremia in patients with liver cirrhosis (11.0 cases were expected), which yielded a standardized incidence ratio of 10.5 (95% confidence interval [CI], 8.8-12.7). Sixty-two cases of bacteremia were nosocomial infections. There were 53 cases of gram-positive bacteremia, 55 cases of gram-negative bacteremia, and 8 cases of polymicrobial bacteremia (1 case of candidemia was excluded from the analysis). The most common cause of death was bleeding from gastroesophageal varices; the second most common cause of death was infection in the respiratory system. The 30-day case-fatality rate was 0.53 (95% CI, 0.39-0.73). Patients with liver cirrhosis had an increased risk of bacteremia and a poor prognosis.
我们研究了肝硬化患者发生菌血症的风险(与丹麦日德兰半岛北部20岁以上丹麦公民的风险进行比较),以及菌血症的类型和30天病死率。我们利用丹麦国家患者登记系统识别出1339例肝硬化患者,并利用日德兰半岛北部菌血症数据库识别菌血症发作情况。我们观察到肝硬化患者中有117例菌血症(预期为11.0例),标准化发病率为10.5(95%置信区间[CI],8.8 - 12.7)。62例菌血症为医院感染。有53例革兰氏阳性菌血症、55例革兰氏阴性菌血症和8例混合菌血症(分析中排除1例念珠菌血症)。最常见的死亡原因是食管胃静脉曲张出血;第二常见的死亡原因是呼吸系统感染。30天病死率为0.53(95%CI,0.39 - 0.73)。肝硬化患者菌血症风险增加且预后较差。