Piedra P A, Dryja D M, LaScolea L J
Department of Pediatrics, School of Medicine, State University of New York, Buffalo.
J Clin Microbiol. 1989 Jun;27(6):1317-9. doi: 10.1128/jcm.27.6.1317-1319.1989.
Children with catheter-associated bacteremia were evaluated for the type of bacteria recovered and the relationship of the bacteria to the predisposing disease. A previously unrecognized observation was that gram-negative isolates, namely, Escherichia coli and Klebsiella sp., were almost exclusively recovered (11 of 12 isolates [92%]) from children with short bowel syndrome (SBS) compared with those from children with other underlying diseases, such as inflammatory bowel disease, malignancies, and other disorders (P less than 0.001). Furthermore, children with SBS had a higher frequency of repeated infection (3.1 catheter-associated infections compared with 1.3 catheter-associated infections in children with other disorders during the same period). Only gram-positive bacteria were isolated from children with malignancies and other predisposing disorders. The very high frequency of catheter-associated gram-negative bacteremia in children with SBS compared with that in children with other bowel disorders, malignancies, and other predisposing diseases requires attention by the clinician in the management of patients in this group.
对患有导管相关菌血症的儿童进行了评估，以确定分离出的细菌类型以及这些细菌与易感疾病的关系。一项先前未被认识到的观察结果是，与患有其他基础疾病（如炎症性肠病、恶性肿瘤和其他疾病）的儿童相比，革兰氏阴性菌分离株，即大肠杆菌和克雷伯菌属，几乎完全（12株分离株中的11株[92%]）从短肠综合征（SBS）患儿中分离出来（P小于0.001）。此外，SBS患儿反复感染的频率更高（同期SBS患儿每例发生3.1次导管相关感染，而其他疾病患儿每例发生1.3次导管相关感染）。仅从患有恶性肿瘤和其他易感疾病的儿童中分离出革兰氏阳性菌。与患有其他肠道疾病、恶性肿瘤和其他易感疾病的儿童相比，SBS患儿导管相关革兰氏阴性菌血症的频率非常高，这需要临床医生在管理该组患者时予以关注。
