Blot Stijn, Vandewoude Koenraad, De Bacquer Dirk, Colardyn Francis
Department of Intensive Care, Ghent University Hospital, B-9000 Ghent, Belgium.
Clin Infect Dis. 2002 Jun 15;34(12):1600-6. doi: 10.1086/340616. Epub 2002 May 23.
Population characteristics and outcomes were retrospectively compared for critically ill patients with nosocomial bacteremia caused by antibiotic-susceptible (AB-S; n=208) or antibiotic-resistant (AB-R; n=120) gram-negative bacteria. No significant differences in severity of illness and comorbidity factors were seen between groups. Patients with bacteremia caused by AB-R strains had a longer hospitalization before the onset of the bacteremia. The in-hospital mortality for patients with bacteremia caused by AB-S strains was 41.8%; for patients infected with AB-R strains, it was 45.0% (P=.576). A multivariate survival analysis demonstrated that older age (P=.009), a high-risk source of bacteremia (abdominal and lower respiratory tract; P=.031), and a high acute physiology and chronic health evaluation II-related expected mortality (P=.032) were independently associated with in-hospital mortality (P<.05). Antibiotic resistance in nosocomial bacteremia caused by gram-negative bacteria does not adversely affect the outcome for critically ill patients.
对由抗生素敏感（AB-S；n=208）或抗生素耐药（AB-R；n=120）革兰氏阴性菌引起的医院获得性菌血症的重症患者的人口统计学特征和结局进行了回顾性比较。两组之间在疾病严重程度和合并症因素方面未见显著差异。由AB-R菌株引起菌血症的患者在菌血症发作前住院时间更长。由AB-S菌株引起菌血症的患者院内死亡率为41.8%；感染AB-R菌株的患者为45.0%（P=0.576）。多因素生存分析表明，年龄较大（P=0.009）、菌血症的高危来源（腹部和下呼吸道；P=0.031）以及较高的急性生理与慢性健康状况评分II相关预期死亡率（P=0.032）与院内死亡率独立相关（P<0.05）。革兰氏阴性菌引起的医院获得性菌血症中的抗生素耐药性对重症患者的结局没有不利影响。
