The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center; University of Pittsburgh; Pittsburgh, PA USA; Department of Critical Care Medicine; University of Pittsburgh, Pittsburgh, PA USA; Department of Medicine; University of Pittsburgh; Pittsburgh, PA USA.
The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center; University of Pittsburgh; Pittsburgh, PA USA; Department of Critical Care Medicine; University of Pittsburgh, Pittsburgh, PA USA.
Virulence. 2014 Jan 1;5(1):4-11. doi: 10.4161/viru.27372. Epub 2013 Dec 11.
Severe sepsis is a leading cause of death in the United States and the most common cause of death among critically ill patients in non-coronary intensive care units (ICU). Respiratory tract infections, particularly pneumonia, are the most common site of infection, and associated with the highest mortality. The type of organism causing severe sepsis is an important determinant of outcome, and gram-positive organisms as a cause of sepsis have increased in frequency over time and are now more common than gram-negative infections. Recent studies suggest that acute infections worsen pre-existing chronic diseases or result in new chronic diseases, leading to poor long-term outcomes in acute illness survivors. People of older age, male gender, black race, and preexisting chronic health conditions are particularly prone to develop severe sepsis; hence prevention strategies should be targeted at these vulnerable populations in future studies.
严重脓毒症是美国的主要死亡原因,也是非冠状动脉重症监护病房(ICU)中危重症患者的最常见死亡原因。呼吸道感染,尤其是肺炎,是最常见的感染部位,与死亡率最高有关。导致严重脓毒症的病原体类型是预后的重要决定因素,随着时间的推移,革兰氏阳性病原体作为脓毒症的病因频率增加,现在比革兰氏阴性感染更为常见。最近的研究表明,急性感染会加重先前存在的慢性疾病或导致新的慢性疾病,导致急性疾病幸存者的长期预后不佳。年龄较大、男性、黑人种族和先前存在的慢性健康状况的人特别容易发生严重脓毒症;因此,未来的研究应该针对这些弱势群体制定预防策略。