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2004-2011 年台湾地区气单胞菌引起的肺炎。

Pneumonia caused by Aeromonas species in Taiwan, 2004-2011.

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. 2013 Aug;32(8):1069-75. doi: 10.1007/s10096-013-1852-6. Epub 2013 Mar 9.

Abstract

We investigated the clinical characteristics of patients with pneumonia caused by Aeromonas species. Patients with pneumonia caused by Aeromonas species during the period 2004 to 2011 were identified from a computerized database of a regional hospital in southern Taiwan. The medical records of these patients were retrospectively reviewed. Of the 84 patients with pneumonia due to Aeromonas species, possible Aeromonas pneumonia was diagnosed in 58 patients, probable Aeromonas pneumonia was diagnosed in 18 patients, and pneumonia due to Aeromonas was conclusively diagnosed in 8 patients. Most of the cases of Aeromonas pneumonia developed in men and in patients of advanced age. A. hydrophila (n = 50, 59.5 %) was the most common pathogen, followed by A. caviae (n = 24, 28.6 %), A. veronii biovar sobria (n = 7, 8.3 %), and A. veronii biovar veronii (n = 3, 3.6 %). Cancer (n = 37, 44.0 %) was the most common underlying disease, followed by diabetes mellitus (n = 27, 32.1 %). Drowning-associated pneumonia developed in 6 (7.1 %) patients. Of 47 patients who were admitted to the intensive care ward, 42 patients developed acute respiratory failure and 24 of those patients died. The overall in-hospital mortality rate was significantly associated with liver cirrhosis, cancer, initial presentation of shock, and usage of mechanical ventilation. In conclusion, Aeromonas species should be considered as one of the causative pathogens of severe pneumonia, especially in immunocompromised patients, and should be recognized as a cause of drowning-associated pneumonia. Cirrhosis, cancer, and shock as the initial presenting symptom are associated with poor outcome.

摘要

我们研究了由气单胞菌引起的肺炎患者的临床特征。从台湾南部一家地区医院的计算机数据库中确定了 2004 年至 2011 年间患有气单胞菌引起的肺炎的患者。回顾性分析这些患者的病历。在 84 例由气单胞菌引起的肺炎患者中,58 例诊断为可能的气单胞菌性肺炎,18 例诊断为可疑气单胞菌性肺炎,8 例诊断为明确的气单胞菌性肺炎。大多数气单胞菌性肺炎发生在男性和老年患者中。最常见的病原体是嗜水气单胞菌(n=50,59.5%),其次是豚鼠气单胞菌(n=24,28.6%)、温和气单胞菌生物型 sobria(n=7,8.3%)和维罗纳气单胞菌生物型 veronii(n=3,3.6%)。癌症(n=37,44.0%)是最常见的基础疾病,其次是糖尿病(n=27,32.1%)。6 例(7.1%)患者发生溺水相关性肺炎。在入住重症监护病房的 47 例患者中,42 例患者发生急性呼吸衰竭,其中 24 例死亡。总的院内死亡率与肝硬化、癌症、初始休克表现和机械通气的使用显著相关。总之,气单胞菌应被视为严重肺炎的一种致病病原体,尤其是在免疫功能低下的患者中,应将其视为溺水相关性肺炎的病因。肝硬化、癌症和休克作为初始表现与不良预后相关。

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