Gradel K O, Schønheyder H C, Pedersen L, Thomsen R W, Nørgaard M, Nielsen H
Forskningens Hus, Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Sdr. Skovvej 15, P.O. Box 365, 9100 Aalborg, Denmark.
Eur J Clin Microbiol Infect Dis. 2006 Mar;25(3):151-8. doi: 10.1007/s10096-006-0110-6.
The aim of this study was to examine the incidence and prognosis of non-typhoid Salmonella bacteraemia in a well-defined population in which complete follow-up investigations had been performed. All patients with non-typhoid Salmonella bacteraemia from 1994 through 2003 in North Jutland County, Denmark, were eligible for the study. Annual incidence rates were calculated for 10-year age groups. The North Jutland County Bacteraemia Database (inclusion of subjects), medical hospital records, the Prescription Registry (redemption of prescription drugs), and the Central Population Registry (deaths) were used as data sources. The outcomes were mortality within 30 and 180 days of the first non-typhoid-Salmonella-positive blood sample. Cox proportional-hazards regression analysis was performed, first with age and comorbidity as evidenced by Charlson index scores, and second with selected clinical and laboratory prognostic variables potentially related to non-typhoid Salmonella bacteraemia per se. A total of 111 non-typhoid Salmonella bacteraemia patients were included in the study. The incidence rate (mean 2.3/100,000 person-years) increased steadily from 1.9/100,000 person-years in the 40-49-year age group to 14.6/100,000 person-years in those >90 years. Twelve (11%) and 24 (22%) patients died within 30 and 180 days, respectively. Cox regression analyses showed that increasing age and, to a higher degree, increasing levels of comorbidity were independently associated with an unfavourable outcome, whereas none of the clinical or laboratory variables studied were strong independent prognostic factors. In conclusion, the presence of comorbid diseases and old age were independently associated with mortality, whereas clinical and laboratory variables were less important.
本研究旨在调查一个有明确界定且已进行完整随访调查的人群中非伤寒沙门菌血症的发病率及预后情况。丹麦北日德兰郡1994年至2003年期间所有非伤寒沙门菌血症患者均符合本研究条件。计算了10岁年龄组的年发病率。北日德兰郡菌血症数据库(纳入研究对象)、医院病历、处方登记处(处方药的使用情况)以及中央人口登记处(死亡情况)用作数据来源。观察的结局指标为首次非伤寒沙门菌阳性血样采集后30天和180天内的死亡率。进行了Cox比例风险回归分析,首先以年龄和Charlson指数评分所反映的合并症作为变量,其次纳入了可能与非伤寒沙门菌血症本身相关的选定临床和实验室预后变量。本研究共纳入111例非伤寒沙门菌血症患者。发病率(平均2.3/100,000人年)从40 - 49岁年龄组的1.9/100,000人年稳步上升至90岁以上人群的14.6/100,000人年。分别有12例(11%)和24例(22%)患者在30天和180天内死亡。Cox回归分析显示,年龄增加以及合并症程度加重与不良结局独立相关,而所研究的临床或实验室变量均不是强有力的独立预后因素。总之,合并症和高龄与死亡率独立相关,而临床和实验室变量的重要性较低。