Zhao Hong, Xu Lichen, Dong Huihui, Hu Jianhua, Gao Hainv, Yang Meifang, Zhang Xuan, Chen Xiaoming, Fan Jun, Ma Weihang
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China.
PLoS One. 2015 Aug 14;10(8):e0136019. doi: 10.1371/journal.pone.0136019. eCollection 2015.
Vibrio vulnificus is a common gram-negative bacterium, which might cause morbidity and mortality in patients following consumption of seafood or exposure to seawater in Southeast China. We retrospectively analyzed clinical data of patients with laboratory confirmed V. vulnificus infection. Twenty one patients were divided into a survival group and a non-surviving (or death) group according to their clinical outcome. Clinical data and measurements were statistically analyzed. Four patients (19.05%) died and five patients gave positive cultures from bile fluid, and 16 other patients gave positive culture from blood or blisters. Ten patients (47.62%) had an underlying liver disease and marine-related events were found in sixteen patients (76.2%). Patients with heavy drinking habits might be at increased mortality (p = 0.028). Clinical manifestations of cellulitis (47.6%), septic shock (42.9%) and multiple organ failure (28.6%) were statistically significant when comparing survivors and non-survivors (p = 0.035, p = 0.021 and p = 0.003, respectively). The laboratory results, including hemoglobin < 9.0 g/L (p = 0.012), platelets < 2.0 × 109 /L, prothrombin time activity (PTA) <20%, decreased serum creatinine and increased urea nitrogen were statistically significant (p = 0.012, p = 0.003, p = 0.028 and p = 0.028, respectively). Patients may be at a higher risk of mortality under situations where they have a history of habitual heavy alcoholic drink consumption (p = 0.028, OR = 22.5, 95%CI 1.5-335.3), accompanied with cellulitis, shock, multiple organ failure, and laboratory examinations that are complicated by decreased platelets, hemoglobin and significantly prolonged prothrombin time (PT).
创伤弧菌是一种常见的革兰氏阴性菌,在中国东南部,食用海鲜或接触海水的患者可能会因此发病甚至死亡。我们回顾性分析了实验室确诊的创伤弧菌感染患者的临床资料。根据临床结局,将21例患者分为存活组和非存活(或死亡)组。对临床资料和测量结果进行了统计学分析。4例患者(19.05%)死亡,5例患者胆汁培养阳性,另有16例患者血液或水疱培养阳性。10例患者(47.62%)有潜在肝脏疾病,16例患者(76.2%)有与海洋相关的事件。有重度饮酒习惯的患者死亡率可能更高(p = 0.028)。比较存活者和非存活者时,蜂窝织炎(47.6%)、感染性休克(42.9%)和多器官功能衰竭(28.6%)的临床表现具有统计学意义(分别为p = 0.035、p = 0.021和p = 0.003)。实验室检查结果,包括血红蛋白<9.0 g/L(p = 0.012)、血小板<2.0×10⁹ /L、凝血酶原时间活性(PTA)<20%、血清肌酐降低和尿素氮升高具有统计学意义(分别为p = 0.012、p = 0.003、p = 0.028和p = 0.028)。有习惯性重度饮酒史的患者在以下情况下死亡率可能更高(p = 0.028,OR = 22.5,95%CI 1.5 - 335.3),伴有蜂窝织炎、休克、多器官功能衰竭,且实验室检查伴有血小板、血红蛋白降低以及凝血酶原时间(PT)显著延长。