Brook I
Walter Reed Army Medical Center, Washington, DC.
J Infect Dis. 1989 Dec;160(6):1071-5. doi: 10.1093/infdis/160.6.1071.
Clinical and microbiologic data of 296 patients with anaerobic bacteremia were reviewed. Anaerobes were isolated with aerobic or facultative bacteremia in 23 instances. The Bacteroides fragilis group accounted for 148 (70%) of 212 isolates of Bacteroides species. B. fragilis accounted for 78% and B. thetaiotaomicron for 14%. Among other species, there were 20 (6%) Fusobacterium organisms, 63 (18%) Clostridium isolates, and 53 (15%) anaerobic cocci. Seventy-five patients died: 40 had B. fragilis group isolates - B. fragilis, 28, and B. thetaiotaomicron, 8 - and 21 had Clostridium organisms isolated. The primary portals of entry were the gastrointestinal tract (42%), decubiti and gangrene (10%), the female genital tract (8%), and the oropharynx (7%). The gastrointestinal tract, decubiti, and gangrene were the predominant sources for B. fragilis and Clostridium organisms, the female genital tract and oropharynx for anaerobic cocci and Fusobacterium species, and the oropharynx for pigmented Bacteroides. Foreign body was associated with Propionibacterium acnes and Clostridium species. Factors predisposing to bacteremia were abscesses, 53; malignancy, 51; surgery, 30; and intestinal obstruction or perforation, 27.
对296例厌氧菌血症患者的临床和微生物学数据进行了回顾。在23例病例中，厌氧菌与需氧菌或兼性菌同时被分离出来。脆弱拟杆菌群占212株拟杆菌属菌株中的148株（70%）。脆弱拟杆菌占78%，多形拟杆菌占14%。在其他菌种中，有20株（6%）梭杆菌属菌、63株（18%）梭菌属分离株和53株（15%）厌氧球菌。75例患者死亡：40例分离出脆弱拟杆菌群菌株——脆弱拟杆菌28株，多形拟杆菌8株——21例分离出梭菌属菌。主要的入侵门户是胃肠道（42%）、褥疮和坏疽（10%）、女性生殖道（8%）和口咽（7%）。胃肠道、褥疮和坏疽是脆弱拟杆菌和梭菌属菌的主要来源，女性生殖道和口咽是厌氧球菌和梭杆菌属菌种的主要来源，口咽是产色素拟杆菌的主要来源。异物与痤疮丙酸杆菌和梭菌属菌种有关。导致菌血症的因素有脓肿53例、恶性肿瘤51例、手术30例、肠梗阻或穿孔27例。
