Azoulay G, Henry J F, Forette F, Berthaux P, Acar J F
Nouv Presse Med. 1977 Oct 15;6(34):3075-6, 3079-81.
Out of 1,251 patients above 65 years of age staying at the Charles Foix Hospital (prolonged hospitalization) and the St. Joseph Hospital (acute cases), 168 had one or more positive blood cultures. Urinary tract infection is a major source of septicemia due to gram negative bacilli. It is important to stress cases of septicemia due to pneumococcal pneumoniae, eschars, and other skin lesions. Mortality varies between 33 and 36%, depending upon the hospital. Collapse, although infrequent, still portends a grave prognosis (61% of cases of collapse led to death at Charles Foix Hospital). The combination of more than two risk factors considerably worsens the prognosis. Hypoproteinemia and dementia are every bit as grave as diabetes and cancer. A better isolation of the microorganisms involved in cases of septicemia in the elderly will lead to a more judicious choice of antibiotics. The administration of chemotherapy immediately after the samples were obtained remains the main guarantee of successful therapy.
在入住查尔斯·富瓦医院(长期住院患者)和圣约瑟夫医院(急症患者)的1251名65岁以上患者中,168人血培养结果呈一项或多项阳性。尿路感染是革兰氏阴性杆菌所致败血症的主要来源。强调由肺炎球菌肺炎、焦痂及其他皮肤损伤引起的败血症病例很重要。死亡率在33%至36%之间,因医院而异。虚脱虽不常见,但仍预示着预后严重(在查尔斯·富瓦医院,61%的虚脱病例导致死亡)。两种以上危险因素并存会使预后大大恶化。低蛋白血症和痴呆与糖尿病和癌症一样严重。更好地分离老年败血症病例中涉及的微生物将有助于更明智地选择抗生素。在获取样本后立即进行化疗仍是治疗成功的主要保障。