Bodey G P, Elting L S, Rodriguez S
Department of Medical Specialties, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Rev Infect Dis. 1991 Jul-Aug;13(4):550-8. doi: 10.1093/clinids/13.4.550.
A total of 296 episodes of bacteremia due to Enterobacter occurred in 281 patients with cancer between 1972 and 1986. The majority of these episodes were caused by Enterobacter cloacae. Seventy-four percent of the patients developed their infection while in the hospital and 55% had received therapeutic antibiotics during the 10 days preceding the onset of the infection. Enterobacter bacteremia was associated with shock in 24% of the patients and with disseminated intravascular coagulation in only 3%. The overall rate of response to therapy was 79% and increased to 85% during the last 5-year period. Only five patients remained afebrile during their infection, but four of these five died. Only 37% of the patients with shock responded to therapy compared with 93% of the patients without shock. The rate of response to therapy was 86% among patients without pulmonary infection compared with only 53% among those with pulmonary infection. The response rate to therapy with a single antibiotic was 73% and that to therapy with two antibiotics was 85%. As single therapeutic agents aminoglycosides were less effective than beta-lactam agents.
1972年至1986年间,281例癌症患者共发生296次因肠杆菌属引起的菌血症。这些菌血症大多数由阴沟肠杆菌引起。74%的患者在住院期间发生感染,55%的患者在感染发作前10天内接受过治疗性抗生素治疗。24%的患者发生肠杆菌属菌血症时伴有休克,仅有3%的患者伴有弥散性血管内凝血。治疗的总体有效率为79%,在最后一个5年期间升至85%。感染期间仅有5例患者无发热,但这5例中有4例死亡。发生休克的患者中治疗有效率仅为37%,而未发生休克的患者中治疗有效率为93%。无肺部感染的患者治疗有效率为86%,而有肺部感染的患者中治疗有效率仅为53%。单一抗生素治疗的有效率为73%,两种抗生素治疗的有效率为85%。作为单一治疗药物,氨基糖苷类药物的效果不如β-内酰胺类药物。