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一项针对芬兰 1998 年至 2007 年期间 10 年来空肠弯曲菌和结肠弯曲菌菌血症的全国性研究,特别参考了临床特征和抗菌药物敏感性。

A nationwide study of Campylobacter jejuni and Campylobacter coli bacteremia in Finland over a 10-year period, 1998-2007, with special reference to clinical characteristics and antimicrobial susceptibility.

机构信息

Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Finland.

出版信息

Clin Infect Dis. 2011 Oct;53(8):e99-e106. doi: 10.1093/cid/cir509.

DOI:10.1093/cid/cir509
PMID:21921217
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3174097/
Abstract

BACKGROUND

Campylobacter bacteremia is an uncommon condition, usually diagnosed in elderly and immunocompromised patients.

METHODS

Blood culture isolates and clinical information were collected for patients with diagnoses of Campylobacter jejuni or Campylobacter coli bacteremia in Finland from 1998 through 2007. Bacterial species were identified by means of polymerase chain reaction analysis, and minimal inhibitory concentrations for ciprofloxacin, clindamycin, doxycycline, erythromycin, gentamicin, meropenem, and metronidazole were determined with an agar dilution method. Medical records and mortality data within 1 year after the bacteremic episode were reviewed.

RESULTS

The study included 76 patients (median age, 46 years), for whom bacterial isolates (C. jejuni in 73, C. coli in 3) and clinical information were available. Most patients (70%) had no significant underlying diseases. The majority (82%) of the isolates were susceptible for all antimicrobial agents tested. However, antimicrobial therapy seemed to have only a limited effect, because no differences could be detected between patients with appropriate empirical antimicrobial treatment and those with delayed appropriate, inappropriate, or no antimicrobial therapy, either in the duration of hospitalization (median, 4 days for both groups) or in attributable mortality. The outcome of the infection was severe in 4 patients infected with C. jejuni; 2 died within 30 days, spondylodiscitis developed in 1, and Guillain-Barré syndrome developed in 1.

CONCLUSIONS

C. jejuni and C. coli bacteremia occurred mainly in moderately young individuals without severe underlying diseases. The bacterial isolates were predominantly susceptible to antimicrobial agents, and the outcome of the disease was typically good, regardless of appropriate or inappropriate antimicrobial treatment given in the hospital.

摘要

背景

弯曲菌菌血症是一种不常见的病症,通常发生于老年人和免疫功能低下的患者中。

方法

从 1998 年至 2007 年,在芬兰对弯曲杆菌(空肠弯曲菌或大肠弯曲菌)菌血症患者的血液培养分离株和临床资料进行了收集。采用聚合酶链反应分析鉴定细菌种类,并采用琼脂稀释法测定环丙沙星、克林霉素、强力霉素、红霉素、庆大霉素、美罗培南和甲硝唑的最小抑菌浓度。对菌血症发作后 1 年内的病历和死亡率数据进行了回顾。

结果

该研究纳入了 76 例患者(中位年龄 46 岁),其中有细菌分离株(73 例为空肠弯曲菌,3 例为大肠弯曲菌)和临床资料。大多数患者(70%)没有明显的基础疾病。大多数分离株(82%)对所有测试的抗菌药物均敏感。然而,抗菌治疗似乎效果有限,因为在接受适当经验性抗菌治疗的患者与接受延迟适当、不适当或无抗菌治疗的患者之间,在住院时间(两组的中位数均为 4 天)或归因死亡率方面,均未观察到差异。4 例感染空肠弯曲菌的患者病情严重;2 例在 30 天内死亡,1 例发生脊椎骨髓炎,1 例发生格林-巴利综合征。

结论

空肠弯曲菌和大肠弯曲菌菌血症主要发生于无严重基础疾病的中等年龄个体中。细菌分离株对抗菌药物的敏感性较高,无论在医院接受适当或不适当的抗菌治疗,疾病的预后通常良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/3174097/eefcd5927834/cidcir509f01_ht.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/3174097/eefcd5927834/cidcir509f01_ht.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/3174097/eefcd5927834/cidcir509f01_ht.jpg

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