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非霍乱弧菌感染的临床表现和预后因素。

Clinical manifestation and prognostic factors of non-cholerae Vibrio infections.

机构信息

Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan.

出版信息

Eur J Clin Microbiol Infect Dis. 2011 Jun;30(6):819-24. doi: 10.1007/s10096-011-1162-9. Epub 2011 Jan 22.

Abstract

Infections caused by non-cholerae Vibrio are uncommon. From July 2004 to June 2010, a total of 218 isolates of Vibrio species were identified from 171 patients treated at Chi Mei Medical Center, Taiwan. A total of 173 isolates of non-cholerae Vibrio species were isolated from 127 patients. The most common type of infection was acute gastroenteritis (59.8%), followed by skin and soft tissue infection (SSTI) (26.0%) and primary bacteremia (11.0%). Other types of infection included biliary tract infection, peritonitis, and acute otitis media, each at a rate of less than 2%. For patients with acute gastroenteritis, V. parahaemolyticus comprised 92.1% of cases, but V. vulnificus was the most common pathogen causing SSTI. All episodes of bacteremia were caused by V. vulnificus. The all-cause mortality rate was 18.8% of 32 patients with SSTI and the fatality rate was significantly higher among patients with decreased albumin, elevated lactate, use of mechanical ventilation, intensive care unit (ICU) admission, and the presence of shock. In conclusion, non-cholerae Vibrio species caused protean manifestations that vary with the infecting Vibrio species. This epidemiological study helps physicians to better understand the clinical characteristics of infections caused by different non-cholerae Vibrio species.

摘要

从 2004 年 7 月至 2010 年 6 月,台湾奇美医学中心共从 171 位病患中分离出 218 株弧菌,其中 173 株为非霍乱弧菌,主要感染途径为急性肠胃炎(59.8%)、皮肤及软组织感染(26.0%)及原发性菌血症(11.0%),其他感染类型还包括胆道感染、腹膜炎及急性中耳炎,各占不到 2%。急性肠胃炎以副溶血性弧菌(92.1%)为主,而皮肤及软组织感染则以创伤弧菌最常见。菌血症的全部病例都是由创伤弧菌引起的。32 位皮肤及软组织感染病患的整体死亡率为 18.8%,且低白蛋白、乳酸值上升、使用机械通气、入住加护病房和休克等患者的死亡率显著较高。总之,非霍乱弧菌的表现形式多样,感染的弧菌种类不同,临床表现也不同。本项流行病学研究有助于医生更好地了解不同非霍乱弧菌引起的感染的临床特征。

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