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机械通气患者中由流感嗜血杆菌引起的肺炎。发病率、转归及危险因素。

Pneumonia due to Haemophilus influenzae among mechanically ventilated patients. Incidence, outcome, and risk factors.

作者信息

Rello J, Ricart M, Ausina V, Net A, Prats G

机构信息

Intensive Care Department, Hospital de la S. Creu i S. Pau., Universitat Autonoma de Barcelona, Spain.

出版信息

Chest. 1992 Nov;102(5):1562-5. doi: 10.1378/chest.102.5.1562.

Abstract

Incidence and potential risk factors for pneumonia due to Haemophilus influenzae in adults treated with mechanical ventilation in a medical-surgical ICU were investigated. Diagnosis was established in 91 episodes and H influenzae was isolated in 20 of them. Mean onset of ventilator-associated pneumonia (VAP) due to H influenzae was 10.8 days after intubation. Six patients with H influenzae VAP died in the ICU. Of 13 risk factors for developing VAP due to H influenzae, an absence of prior antibiotic treatment was the only variable which had statistical significance (p < 0.001). In these mechanically ventilated patients, Haemophilus influenzae was a common causative agent for VAP, frequently associated with Gram-positive cocci. Episodes of H influenzae VAP were associated with a lower mortality compared with other etiologies. The epidemiologic and clinical findings indicate that patients without a prior antimicrobial treatment have increased susceptibility to infections of the airway by H influenzae.

摘要

对一所内科-外科重症监护病房中接受机械通气治疗的成年患者因流感嗜血杆菌所致肺炎的发病率及潜在危险因素进行了调查。确诊了91例病例,其中20例分离出流感嗜血杆菌。流感嗜血杆菌所致呼吸机相关性肺炎(VAP)的平均发病时间为插管后10.8天。6例流感嗜血杆菌VAP患者在重症监护病房死亡。在导致流感嗜血杆菌VAP的13个危险因素中,未接受过先前抗生素治疗是唯一具有统计学意义的变量(p<0.001)。在这些机械通气患者中,流感嗜血杆菌是VAP的常见病原体,常与革兰氏阳性球菌相关。与其他病因相比,流感嗜血杆菌VAP发作的死亡率较低。流行病学和临床研究结果表明,未接受过先前抗菌治疗的患者对流感嗜血杆菌引起的气道感染易感性增加。

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