Lay Chorng-Jang, Zhuang Han-Juan, Ho Yu-Huai, Tsai Yeong-Shu, Wang Lih-Shinn, Tsai Chen-Chi
Division of Infectious Disease, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
Intern Med. 2010;49(22):2415-21. doi: 10.2169/internalmedicine.49.4117. Epub 2010 Nov 15.
Part of Aeromonas bacteremia is polymicrobial infection. However, a clinical comparison of monomicrobial and polymicrobial Aeromonas bacteremia has not hitherto been reported.
A retrospective analysis of medical records of patients with Aeromonas bacteremia at three large referral hospitals in Taiwan for an 8-year period (2001-2008) was conducted.
There were 154 patients with monomicrobial Aeromonas bacteremia and 62 patients with polymicrobial Aeromonas bacteremia. In the polymicrobial infections, E. coli was the most common combined pathogen (42%), followed by Klebsiella spp. (24%) and Enterobacter spp. (16%). Multivariate logistic regression analysis revealed solid cancer as the risk factor for polymicrobial Aeromonas bacteremia, with male gender and cirrhosis as risk factors for monomicrobial Aeromonas bacteremia. However, of all types of solid cancer, hepatoma was associated with monomicrobial Aeromonas bacteremia. APACHE II score was the most important prognostic factor in both groups.
Aeromonas bacteremia in patients with cirrhosis or male gender tended to be monomicrobial. Polymicrobial Aeromonas bacteremia was associated with solid cancers. In either polymicrobial or monomicrobial Aeromonas bacteremia, prognosis could be predicted according to disease severity measured by APACHE II score.
气单胞菌血症部分为混合感染。然而，此前尚未有关于单微生物和气单胞菌混合菌血症的临床比较报道。
对台湾三家大型转诊医院8年期间（2001 - 2008年）气单胞菌血症患者的病历进行回顾性分析。
有154名单微生物气单胞菌血症患者和62名混合菌气单胞菌血症患者。在混合感染中，大肠杆菌是最常见的合并病原体（42%），其次是克雷伯菌属（24%）和肠杆菌属（16%）。多因素逻辑回归分析显示实体癌是混合菌气单胞菌血症的危险因素，男性和肝硬化是单微生物气单胞菌血症的危险因素。然而，在所有类型的实体癌中，肝癌与单微生物气单胞菌血症相关。APACHE II评分是两组中最重要的预后因素。
肝硬化患者或男性的气单胞菌血症倾向于单微生物感染。混合菌气单胞菌血症与实体癌相关。在混合菌或单微生物气单胞菌血症中，可根据APACHE II评分所衡量的疾病严重程度预测预后。
