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[拟杆菌引起的菌血症。50例病例分析]

[Bacteremia caused by Bacteroides. An analysis of 50 episodes].

作者信息

Berenguer J, Cuadros J A, Betriu C, Muñoz P, Moreno J J

出版信息

Enferm Infecc Microbiol Clin. 1989 Jun-Jul;7(6):307-11.

PMID:2490445
Abstract

During the 32 months between October 1984 and May 1987 there were 72,800 admissions in our center; 31,523 blood cultures were undertaken and in 3,831 of them (11.5%) at least one significant organism was recovered; 6.7% of blood cultures yielded anaerobic bacteria, and 3.1% Bacteroides spp. In the 1,478 instances of bacteremia recorded during that period, the relative frequencies of bacteremia by anaerobic bacteria and by Bacteroides were 8.6% and 3.9%, respectively. In overall 50 Bacteroides bacteremias (47 due to Bacteroides fragilis and 3 to Bacteroides spp), 32 (64%) were hospital acquired and 14 (28%) postsurgical. Their most common source was the abdominal cavity (25, 50%), followed by the skin and soft tissues (7, 14%), feminine pelvis (4, 8%), miscellaneous (8, 16%), and unknown (7, 14%). Fifteen bacteremias (30%) were polymicrobial, 20 (40%) were associated with septic shock, and 15 (30%) with renal failure. Overall mortality rate was 52%, and that directly attributable to bacteremia was 32%. Poor prognostic predictors included the source from a perforated viscus, septic shock, renal failure or gastrointestinal hemorrhage, and the absence of adequate antimicrobial therapy.

摘要

在1984年10月至1987年5月的32个月期间,我们中心共有72,800例住院患者;共进行了31,523次血培养,其中3,831次(11.5%)培养出至少一种有意义的微生物;6.7%的血培养分离出厌氧菌,3.1%分离出拟杆菌属。在该期间记录的1,478例菌血症病例中,厌氧菌和拟杆菌所致菌血症的相对发生率分别为8.6%和3.9%。在总共50例拟杆菌菌血症(47例由脆弱拟杆菌引起,3例由其他拟杆菌属引起)中,32例(64%)为医院获得性感染,14例(28%)为术后感染。其最常见的来源是腹腔(25例,50%),其次是皮肤和软组织(7例,14%)、女性盆腔(4例,8%)、其他(8例,16%)和不明来源(7例,14%)。15例菌血症(30%)为多菌感染,20例(40%)伴有感染性休克,15例(30%)伴有肾衰竭。总体死亡率为52%,直接由菌血症导致的死亡率为32%。预后不良的预测因素包括来自穿孔脏器的感染源、感染性休克、肾衰竭或胃肠道出血,以及缺乏充分的抗菌治疗。

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