Weischer M, Kolmos H J
Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, Denmark.
J Hosp Infect. 1992 Jan;20(1):15-24. doi: 10.1016/0195-6701(92)90057-s.
In order to study the epidemiology of invasive enterobacter infections, data from 53 consecutive cases of bacteraemia due to this organism were compared with data from 72 randomly selected cases of Escherichia coli bacteraemia. The cases occurred among patients admitted to a Danish University hospital over a 6-year period. Forty-eight cases were due to Enterobacter cloacae and five were due to Ent. aerogenes. Enterobacter bacteraemia was more often of nosocomial origin than E. coli bacteraemia and more often polymicrobial. Patients suffering from enterobacter bacteraemia were younger than E. coli patients, and males tended to predominate. Apart from cancer of the prostate, other malignant diseases tended to be more frequent among patients with enterobacter bacteraemia than among E. coli patients. Enterobacter bacteraemia was more often associated with a focus in central venous catheters and burns, whereas patients with E. coli bacteraemia more often showed a focus of infection in the urinary tract. Patients with enterobacter bacteraemia and a microbiologically documented focus in the respiratory tract or the urinary tract more often had an endotracheal tube or indwelling urinary catheter compared to patients with E. coli bacteraemia with a similar focus of infection. In patients with no microbiologically documented focus enterobacter bacteraemia was more often associated with the presence of central and peripheral venous catheters. During the preceding 12 weeks patients with enterobacter bacteraemia, more often than E. coli patients, had been treated with beta-lactam antibiotics, especially penicillins. The close association with devices may indicate that Enterobacter has a special affinity for foreign body material. Studies are planned to elucidate this aspect in further detail.
为研究侵袭性肠杆菌感染的流行病学,将53例连续发生的由该菌引起的菌血症病例数据与72例随机选取的大肠杆菌菌血症病例数据进行了比较。这些病例发生在一所丹麦大学医院6年间收治的患者中。48例由阴沟肠杆菌引起,5例由产气肠杆菌引起。肠杆菌菌血症比大肠杆菌菌血症更常源于医院感染,且更常为多菌感染。患肠杆菌菌血症的患者比患大肠杆菌菌血症的患者年轻,且男性居多。除前列腺癌外,肠杆菌菌血症患者中其他恶性疾病往往比大肠杆菌菌血症患者更常见。肠杆菌菌血症更常与中心静脉导管和烧伤部位感染相关,而大肠杆菌菌血症患者更常表现为泌尿系统感染。与有类似感染部位的大肠杆菌菌血症患者相比,有呼吸道或泌尿系统微生物学证实感染部位的肠杆菌菌血症患者更常使用气管内插管或留置导尿管。在无微生物学证实感染部位的患者中,肠杆菌菌血症更常与中心和外周静脉导管的存在相关。在之前的12周内,肠杆菌菌血症患者比大肠杆菌菌血症患者更常接受β-内酰胺类抗生素治疗,尤其是青霉素。与医疗器械的密切关联可能表明肠杆菌对异物材料有特殊亲和力。计划开展研究以进一步详细阐明这一方面。