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金黄色葡萄球菌菌血症

Staphylococcus aureus bacteremia.

作者信息

Akbar D H, Mushtaq M A, El-Tahawi A T, Bahnasy A A

机构信息

King Abdulaziz University Hospital, Jeddah 21415, PO Box 18298, Kingdom of Saudi Arabia.

出版信息

Saudi Med J. 2000 Feb;21(2):171-4.

Abstract

OBJECTIVES

To study the episodes of Staph.aureus bacteremia diagnosed at King Abdulaziz University Hospital, to determine the source of infection, risk factors, the outcome of treatment and to compare our results with those reported in the literature.

METHODS

A retrospective study in which the episodes of Staph.aureus bacteremia diagnosed at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia in the period from June 1996 to December 1998 were analyzed.

RESULTS

A total of 103 episodes of Staph.aureus bacteremia were diagnosed in 95 patients with a mean age of 33.61 years (range 2 months to 90 years) and male:female ratio of 1.9:1. More than 50% of patients were Saudi nationals. Hospital-acquired infection was detected in 74% of the episodes versus 25% community-acquired. Methicillin resistant Staph.aureus was found in 29% of the episodes. Intravenous catheters and wounds were the main sources of bacteremic episodes (29% and 21%). The overall mortality was 32% with significant association with old age, diabetes mellitus and hemodialysis for renal failure. Risk factors such as surgical wounds, diabetes mellitus and malignancy, were more frequently associated with hospital-acquired than community-acquired bacteremia. Infective endocarditis was higher in patients with community-acquired bacteremia who had unknown source of infection.

CONCLUSIONS

As discussed in the text, our results are comparable with those reported in the literature. Insertion of intravenous catheters under aseptic precaution, better care and judicious limitation of patients length of exposure to central line, in addition to proper wound dressings could reduce the frequency of blood stream infections.

摘要

目的

研究在阿卜杜勒阿齐兹国王大学医院诊断出的金黄色葡萄球菌菌血症发作情况,确定感染源、危险因素、治疗结果,并将我们的结果与文献报道的结果进行比较。

方法

进行一项回顾性研究,分析1996年6月至1998年12月期间在沙特阿拉伯王国吉达市阿卜杜勒阿齐兹国王大学医院诊断出的金黄色葡萄球菌菌血症发作情况。

结果

共诊断出103例金黄色葡萄球菌菌血症发作,涉及95名患者,平均年龄33.61岁(范围为2个月至90岁),男女比例为1.9:1。超过50%的患者为沙特国民。74%的发作病例检测到医院获得性感染,而社区获得性感染为25%。29%的发作病例中发现耐甲氧西林金黄色葡萄球菌。静脉导管和伤口是菌血症发作的主要来源(分别为29%和21%)。总体死亡率为32%,与老年、糖尿病和肾衰竭血液透析有显著关联。手术伤口、糖尿病和恶性肿瘤等危险因素与医院获得性菌血症的关联比社区获得性菌血症更频繁。社区获得性菌血症且感染源不明的患者感染性心内膜炎发生率更高。

结论

如文中所讨论的,我们的结果与文献报道的结果具有可比性。在无菌预防措施下插入静脉导管、更好的护理以及合理限制患者接触中心静脉导管的时间,此外进行适当的伤口敷料处理,可以降低血流感染的发生率。

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