Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
J Microbiol Immunol Infect. 2009 Aug;42(4):336-42.
Fusobacterium bacteremia is uncommon, accounting for approximately 0.9% of patients with bacteremia. The objectives of this study were to evaluate the incidence and clinical significance of blood cultures positive for Fusobacterium spp., risk factors for mortality, and the impact of antimicrobial therapy on clinical outcomes.
This was a 5-year retrospective study in which the medical records of patients with Fusobacterium bacteremia treated at the Division of Infectious Diseases, Chang Gung Memorial Hospital, Taoyuan, Taiwan, from 2002 to 2006 were analyzed.
Fusobacterium spp. accounted for 0.74% of 16,676 positive blood cultures. 123 patients were included in the study, 53 of whom had polymicrobial bacteremia (43.1%). Fusobacterium nucleatum was the most common species identified (41.5%). The mean age +/- standard deviation of the patients was 62.6 +/- 18.9 years. The most common sources of bacteremia were the gastrointestinal tract, lower respiratory tract, and skin and soft tissue. Thirty four patients (27.6%) had no definite loci of infection. The overall mortality rate was 40.7% (50 patients), which was not associated with inappropriate empirical antibiotic therapy (p = 0.950), Fusobacterium spp., source of infection, or polymicrobial bacteremia. Shock, lack of fever at presentation, and underlying diseases (heart failure, renal insufficiency, or malignancy) were independent risk factors for mortality.
Fusobacterium bacteremia was associated with a high mortality rate for patients with renal insufficiency, heart failure, or malignancy. Delayed start of appropriate antimicrobial therapy did not impact the outcomes.
梭菌菌血症较为少见，约占菌血症患者的 0.9%。本研究旨在评估血液培养阳性的梭菌属感染的发生率和临床意义、死亡率的危险因素，以及抗菌治疗对临床结局的影响。
这是一项回顾性研究，对 2002 年至 2006 年在台湾长庚纪念医院感染科治疗的梭菌菌血症患者的病历进行了分析。
梭菌属占 16676 例阳性血培养的 0.74%。共纳入 123 例患者，其中 53 例为混合菌血症（43.1%）。最常见的鉴定菌种为核梭杆菌（41.5%）。患者的平均年龄为 62.6±18.9 岁。菌血症的最常见来源为胃肠道、下呼吸道和皮肤软组织。34 例（27.6%）患者无明确感染部位。总的死亡率为 40.7%（50 例），与经验性抗菌治疗不当（p=0.950）、梭菌属、感染源或混合菌血症无关。休克、无发热表现和基础疾病（心力衰竭、肾功能不全或恶性肿瘤）是死亡的独立危险因素。
梭菌菌血症与肾功能不全、心力衰竭或恶性肿瘤患者的高死亡率相关。延迟开始适当的抗菌治疗不会影响结局。
