Muttaiyah Sharmini, Paviour Sue, Buckwell Leanne, Roberts Sally A
Department of Clinical Microbiology, Auckland City Hospital, Auckland.
N Z Med J. 2007 Nov 9;120(1265):U2809.
To determine the clinical significance and outcomes for patients with anaerobic bacteraemia at our institution over a 2-year period.
The isolates were identified from the laboratory database and patient information obtained from clinical records.
Anaerobes were isolated from 140 blood culture sets taken from 114 patients. For 59 patients, the isolates were considered to be contaminants. Of note, all Propionibacterium spp. were considered contaminants. For the patients with true bacteraemias, the most likely source of infection was intra-abdominal, 26 (50%), mucositis associated with neutropaenia contributed to by cytotoxic therapy, 11 (19%), skin and soft tissue, 4 (8%), pelvic, 5 (9%) and oropharyngeal, 4 (8%). Thirty-five patients were on appropriate therapy prior to the availability culture results. Five patients died but only one death was directly attributable to anaerobic bacteraemia.
At our institution, anaerobes accounted for 2.3% of all positive blood cultures. Excluding Propionibacterium spp., most isolates were considered clinically significant. The most common source for the bacteraemia was intra-abdominal infection, followed by mucositis in neutropaenic patients. Empiric antimicrobial therapy provided appropriate cover for two-thirds of the patients. One death was directly attributable to anaerobic bacteraemia.
确定我院2年内厌氧菌血症患者的临床意义及转归。
从实验室数据库及临床记录中获取的患者信息中鉴定分离菌株。
从114例患者的140份血培养标本中分离出厌氧菌。59例患者的分离菌株被视为污染物。值得注意的是，所有丙酸杆菌属均被视为污染物。对于真正发生菌血症的患者，最可能的感染源是腹腔内，26例（50%）；细胞毒性治疗导致的与中性粒细胞减少相关的黏膜炎，11例（19%）；皮肤和软组织，4例（8%）；盆腔，5例（9%）；口咽，4例（8%）。35例患者在获得培养结果之前接受了适当的治疗。5例患者死亡，但只有1例死亡直接归因于厌氧菌血症。
在我院，厌氧菌占所有阳性血培养的2.3%。排除丙酸杆菌属，大多数分离菌株被认为具有临床意义。菌血症最常见的来源是腹腔内感染，其次是中性粒细胞减少患者的黏膜炎。经验性抗菌治疗为三分之二的患者提供了适当的覆盖。1例死亡直接归因于厌氧菌血症。
