De Keukeleire Steven, Wybo Ingrid, Naessens Anne, Echahidi Fedoua, Van der Beken Mieke, Vandoorslaer Kristof, Vermeulen Stefan, Piérard Denis
Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Anaerobe. 2016 Jun;39:54-9. doi: 10.1016/j.anaerobe.2016.02.009. Epub 2016 Feb 23.
In order to identify current trends in anaerobic bacteraemia, a 10-year retrospective study was performed in the University Hospital Brussel, Belgium. All clinically relevant bacteraemia detected from 2004 until 2013 were included. Medical records were reviewed in an attempt to define clinical parameters that might be associated with the occurrence of anaerobic bacteraemia. 437 of the isolated organisms causing anaerobic bacteraemia were thawed, subcultured and reanalyzed using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF). There were an average of 33 cases of anaerobic bacteraemia per year during 2004-2008 compared to an average of 27 cases per year during 2009-2013 (P = 0.017), corresponding to a decrease by 19% between the first and the latter period. Also, the total number of cases of anaerobic bacteraemia per 100,000 patient days decreased from 17.3 in the period from 2004 to 2008 to 13.7 in the period 2009 to 2013 (P = 0.023). Additionally, the mean incidence of anaerobic bacteraemia decreased during the study period (1.27/1000 patients in 2004 vs. 0.94/1000 patients in 2013; P = 0.008). In contrast, the proportion of isolated anaerobic bacteraemia compared to the number of all bacteraemia remained stable at 5%. Bacteroides spp. and Parabacteroides spp. accounted for 47.1% of the anaerobes, followed by 14.4% Clostridium spp., 12.6% non-spore-forming Gram-positive rods, 10.5% anaerobic cocci, 8.2% Prevotella spp. and other Gram-negative rods and 7.1% Fusobacterium spp. The lower gastrointestinal tract (47%) and wound infections (10%) were the two most frequent sources for bacteraemia, with the origin remaining unknown in 62 cases (21%). The overall mortality rate was 14%. Further studies focusing on the antimicrobial susceptibility and demographic background of patients are needed to further objectify the currently observed trends.
为了确定当前厌氧菌血症的趋势，在比利时布鲁塞尔大学医院进行了一项为期10年的回顾性研究。纳入了2004年至2013年期间检测到的所有临床相关菌血症病例。查阅病历以确定可能与厌氧菌血症发生相关的临床参数。对437株引起厌氧菌血症的分离菌株进行解冻、传代培养，并使用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF）进行重新分析。2004 - 2008年期间每年平均有33例厌氧菌血症病例，而2009 - 2013年期间每年平均有27例（P = 0.017），相当于前后两个时期减少了19%。此外，每100,000个患者日的厌氧菌血症病例总数从2004年至2008年期间的17.3例降至2009年至2013年期间的13.7例（P = 0.023）。此外，在研究期间厌氧菌血症的平均发病率有所下降（2004年为1.27/1000患者，2013年为0.94/1000患者；P = 0.008）。相比之下，分离出的厌氧菌血症病例占所有菌血症病例的比例保持稳定，为5%。拟杆菌属和副拟杆菌属占厌氧菌的47.1%，其次是梭菌属占14.4%，无芽孢革兰氏阳性杆菌占12.6%，厌氧球菌占10.5%，普雷沃菌属和其他革兰氏阴性杆菌占8.2%，梭杆菌属占7.1%。下消化道（47%）和伤口感染（10%）是菌血症最常见的两个来源，62例（21%）病例的感染源不明。总体死亡率为14%。需要进一步开展针对患者抗菌药敏性和人口统计学背景的研究，以进一步明确目前观察到的趋势。
