a Infectious Diseases Unit, Rambam Health Care Campus and Faculty of Medicine , Technion-Israel Institute of Technology , Haifa , Israel ;
b Pediatric Infectious Diseases Unit, Rambam Health Care Campus and Faculty of Medicine , Technion-Israel Institute of Technology , Haifa , Israel ;
Infect Dis (Lond). 2016 Nov-Dec;48(11-12):796-9. doi: 10.1080/23744235.2016.1195916. Epub 2016 Jun 20.
Campylobacter bacteraemia (CB) is rare and usually occurs in immune-compromised patients. In this study we examined the incidence and epidemiology of CB in one institution over 15.5 years.
The medical records of all the consecutive patients with CB admitted to our hospital from 2000 to 2015 were retrospectively reviewed. Clinical characteristics, microbiologic and outcome data were collected.
During the study period, 65 patients with CB were identified. The majority of the patients were middle aged and immune-compromised. Campylobacter jejuni was the most commonly identified species (33/47, 70%). The main underlying conditions were haematological malignancies (43%) and chronic liver disease (14%). Fifty-seven percent of the patients were receiving immunosuppressive therapy at the time of bacteraemia. The most common presenting symptoms were fever (85%), diarrhoea (40%), abdominal pain (40%), and nausea and vomiting (40%). Of the isolates tested, 97% were susceptible to macrolides, and only 35% were susceptible to quinolones. Susceptibility to quinolones decreased over the years. Most patients did not receive adequate empiric antibiotic treatment (81.5%) and about 20% never received directed therapy. Mortality and relapse rates were low (5% each). There was no association between adequate empirical or definitive antibiotic therapy and adverse outcomes.
The main predisposing factor for Campylobacter bacteraemia in our cohort was immunosuppression. Prognosis was generally favourable regardless of appropriateness of antibiotic therapy.
弯曲杆菌菌血症(CB)较为罕见,通常发生于免疫功能低下的患者。在本研究中,我们研究了一家机构在 15.5 年期间的弯曲杆菌菌血症的发生率和流行病学。
回顾性分析了 2000 年至 2015 年期间我院收治的所有连续弯曲杆菌菌血症患者的病历。收集了临床特征、微生物学和预后数据。
在研究期间,共确定了 65 例弯曲杆菌菌血症患者。大多数患者为中年且免疫功能低下。空肠弯曲菌是最常见的鉴定菌种(33/47,70%)。主要的潜在疾病是血液系统恶性肿瘤(43%)和慢性肝病(14%)。57%的患者在菌血症时正在接受免疫抑制治疗。最常见的临床表现为发热(85%)、腹泻(40%)、腹痛(40%)、恶心和呕吐(40%)。在检测的分离株中,97%对大环内酯类敏感,只有 35%对喹诺酮类敏感。喹诺酮类的敏感性逐年下降。大多数患者未接受充分的经验性抗生素治疗(81.5%),约 20%从未接受过针对性治疗。死亡率和复发率均较低(各为 5%)。充分的经验性或确定性抗生素治疗与不良预后之间无关联。
本队列中弯曲杆菌菌血症的主要诱发因素是免疫抑制。无论抗生素治疗是否恰当,预后通常良好。