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肠球菌在血流感染中的作用:德国大学医院的一项单中心回顾性观察研究结果

On the Role of Enterococci in the Bloodstream: Results of a Single-Center, Retrospective, Observational Study at a German University Hospital.

作者信息

Frickmann Hagen, Köller Kerstin, Veil Irina, Weise Mirjam, Ludyga Alicja, Schwarz Norbert Georg, Warnke Philipp, Podbielski Andreas

机构信息

Department of Tropical Medicine at the Bernhard Nocht Institute, Bundeswehr Hospital Hamburg, Hamburg, Germany.

Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany.

出版信息

Eur J Microbiol Immunol (Bp). 2017 Oct 19;7(4):284-295. doi: 10.1556/1886.2017.00030. eCollection 2017 Dec 18.

Abstract

This study assesses the clinical relevance of vancomycin-susceptible enterococci in bacteremic patients and compares it with bacteremia due to and . During a 5-year-study interval, clinical and diagnostic features of patients with enterococcal bacteremia were compared to those of patients with or bacteremia. Each patient was only counted once per hospital stay. During the 5-year study interval, data from 267 patients with enterococcal bacteremia and from 661 patients with bacteremia due to or were evaluated. In spite of a comparable risk of death, patients with enterococci more frequently needed catecholamines and invasive ventilation. Furthermore, enterococci were more frequently associated with a mixed bacterial flora in bloodstream infections. While fatal sepsis due to and was associated with typical shock symptoms, this association was not confirmed for enterococci. Although enterococcal bacteremia is associated with a risk of dying comparable to that with bacteremia due to and , a lower pathogenic potential of enterococci in bloodstream has to be acknowledged. Enterococci in the bloodstream are more likely to be an epiphenomenon of impending death than its major cause.

摘要

本研究评估了万古霉素敏感肠球菌在菌血症患者中的临床相关性,并将其与由[未提及的两种细菌]引起的菌血症进行比较。在为期5年的研究期间,将肠球菌菌血症患者的临床和诊断特征与[未提及的两种细菌]菌血症患者的特征进行了比较。每位患者在每次住院期间仅统计一次。在为期5年的研究期间,对267例肠球菌菌血症患者和661例由[未提及的两种细菌]引起的菌血症患者的数据进行了评估。尽管死亡风险相当,但肠球菌菌血症患者更频繁地需要使用儿茶酚胺和有创通气。此外,在血流感染中,肠球菌更常与混合菌群相关。虽然由[未提及的两种细菌]引起的致命性脓毒症与典型的休克症状相关,但肠球菌并未证实有这种关联。尽管肠球菌菌血症与[未提及的两种细菌]菌血症的死亡风险相当,但必须承认肠球菌在血流中的致病潜力较低。血流中的肠球菌更有可能是即将死亡的一种附带现象,而非主要死因。

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