入住重症监护病房的自发性需氧革兰氏阴性杆菌性脑膜炎成人患者。
Adults with spontaneous aerobic Gram-negative bacillary meningitis admitted to the intensive care unit.
作者信息
Bouadma L, Schortgen F, Thomas R, Wutke S, Lellouche F, Régnier B, Wolff M
机构信息
Service de Réanimation Médicale et des Maladies Infectieuses, Hôpital Bichat-Claude-Bernard, Paris.
出版信息
Clin Microbiol Infect. 2006 Mar;12(3):287-90. doi: 10.1111/j.1469-0691.2005.01346.x.
The characteristics of spontaneous aerobic Gram-negative bacillary meningitis (AGNBM) were determined in 40 adults requiring admission to an intensive care unit (ICU) during a 16-year period in ten French ICUs. Eight infections were hospital-acquired and most patients had predisposing factors, mainly chronic alcoholism and an immunocompromised status. Three immunosuppressed patients had disseminated strongyloidiasis. Gram's stain, cerebrospinal fluid and blood cultures were positive for 85%, 98% and 80% of cases, respectively. Escherichia coli (57%) and Klebsiella pneumoniae (17%) were the most frequent pathogens. In-ICU mortality was 38%. Spontaneous AGNBM is a rare complication of bacteraemia in adults. The severity of predisposing underlying diseases might explain the poor prognosis despite appropriate antimicrobial therapy.
在法国的10个重症监护病房（ICU）的16年期间，对40名需要入住ICU的成年患者的自发性需氧革兰氏阴性杆菌性脑膜炎（AGNBM）特征进行了测定。8例感染为医院获得性，大多数患者有易感因素，主要是慢性酒精中毒和免疫功能低下状态。3例免疫抑制患者有播散性类圆线虫病。革兰氏染色、脑脊液和血培养阳性率分别为85%、98%和80%。大肠埃希菌（57%）和肺炎克雷伯菌（17%）是最常见的病原体。ICU内死亡率为38%。自发性AGNBM是成人菌血症的一种罕见并发症。尽管进行了适当的抗菌治疗，但潜在基础疾病的严重程度可能解释了预后不良的原因。
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