早产儿血培养后的死亡率：革兰氏阴性菌血症和念珠菌血症时死亡率增加，但革兰氏阳性菌血症时死亡率未增加。

Mortality following blood culture in premature infants: increased with Gram-negative bacteremia and candidemia, but not Gram-positive bacteremia.

作者信息

Benjamin Daniel K, DeLong Elizabeth, Cotten Charles M, Garges Harmony P, Steinbach William J, Clark Reese H

机构信息

Duke Clinical Research Institute, Durham, NC 27715, USA.

出版信息

J Perinatol. 2004 Mar;24(3):175-80. doi: 10.1038/sj.jp.7211068.

DOI:10.1038/sj.jp.7211068

PMID:14985775

Abstract

OBJECTIVE

To describe survival following nosocomial bloodstream infections and quantify excess mortality associated with positive blood culture.

STUDY DESIGN

Multicenter cohort study of premature infants.

RESULTS

First blood culture was negative for 4648/5497 (78%) of the neonates--390/4648 (8%) died prior to discharge. Mortality prior to discharge was 19% in the 161 infants with Gram-negative rod (GNR) bacteremia, 8% in the 854 neonates with coagulase negative staphylococcus (CONS), 6% in the 169 infants infected with other Gram-positive bacteria (GP-o), and 26% in the 115 neonates with candidemia. The excess 7-day mortality was 0% for Gram-positive organisms and 83% for GNR bacteremia and candidemia. Using negative blood culture as referent, GNR [hazard ratio (HR)=2.61] and candidemia (HR=2.27) were associated with increased mortality; CONS (HR=1.08) and GP-o (HR=0.97) were not.

CONCLUSIONS

Nosocomial GNR bacteremia and candidemia were associated with increased mortality but Gram-positive bacteremia was not.

摘要

目的

描述医院获得性血流感染后的生存率，并量化血培养阳性相关的额外死亡率。

研究设计

对早产儿进行的多中心队列研究。

结果

4648/5497（78%）的新生儿首次血培养结果为阴性，其中390/4648（8%）在出院前死亡。161例革兰氏阴性杆菌（GNR）菌血症婴儿的出院前死亡率为19%，854例凝固酶阴性葡萄球菌（CONS）感染新生儿的出院前死亡率为8%，169例感染其他革兰氏阳性菌（GP-o）的婴儿出院前死亡率为6%，115例念珠菌血症新生儿的出院前死亡率为26%。革兰氏阳性菌的7天额外死亡率为0%，GNR菌血症和念珠菌血症的7天额外死亡率为83%。以血培养阴性为对照，GNR（风险比[HR]=2.61）和念珠菌血症（HR=2.27）与死亡率增加相关；CONS（HR=1.08）和GP-o（HR=0.97）则不然。