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非伤寒型沙门氏菌菌血症的相关因素:一项病例对照研究。

Correlates of non-typhoidal Salmonella bacteraemia: A case-control study.

机构信息

Medical Department D, Shaare Zedek Medical Centre, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel.

Infectious Diseases Unit, Shaare Zedek Medical Centre, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel.

出版信息

Int J Infect Dis. 2019 Apr;81:170-175. doi: 10.1016/j.ijid.2019.01.028. Epub 2019 Jan 23.

Abstract

OBJECTIVE

Limited up-to-date evidence exists on host-related characteristics of non-typhoidal Salmonella (NTS) bacteraemia in high-income countries. Correlates of NTS bacteraemia in Israel were examined in this study.

METHODS

A case-control study was conducted using the medical records of patients hospitalized with NTS bacteraemia in Jerusalem during 1997-2016 (n=106; 57 children, 49 adults). Two control groups were included: (1) randomly selected controls (n=101), who were patients hospitalized due to bacteraemia with other pathogens; (2) patients with salmonellosis without bacteraemia (n=112). Age-stratified logistic regression models were constructed.

RESULTS

In children, a recent emergency room visit was associated with an increased likelihood of NTS bacteraemia. In adults, the likelihood of NTS bacteraemia versus salmonellosis increased in relation to Charlson comorbidity score (adjusted odds ratio (aOR) 1.29, 95% confidence interval (CI) 1.00-1.66, for each 1-point increase in the score), while an inverse association was found with haemoglobin level (aOR 0.72, 95% CI 0.54-0.95). Steroid therapy increased the likelihood of NTS bacteraemia compared to patients with bacteraemia due to other pathogens (aOR 5.22, 95% CI 1.01-26.93).

CONCLUSIONS

In children, NTS bacteraemia was probably present at their prior emergency room visit. A high comorbidity burden increased the likelihood of bacteraemia in adults with Salmonella infection, while haemoglobin level might be protective.

摘要

目的

在高收入国家,有关非伤寒型沙门氏菌(NTS)菌血症宿主相关特征的最新证据有限。本研究旨在研究以色列 NTS 菌血症的相关因素。

方法

采用病例对照研究,对 1997 年至 2016 年耶路撒冷因 NTS 菌血症住院的患者(n=106;57 例儿童,49 例成人)的病历进行分析。纳入了两组对照:(1)随机选择的对照组(n=101),因其他病原体菌血症住院的患者;(2)无菌血症的沙门氏菌病患者(n=112)。构建了年龄分层的逻辑回归模型。

结果

在儿童中,近期急诊就诊与 NTS 菌血症的发生几率增加相关。在成人中,与沙门氏菌病相比,NTS 菌血症的发生几率与 Charlson 合并症评分相关(调整后的优势比(aOR)1.29,95%置信区间(CI)1.00-1.66,评分每增加 1 分),而与血红蛋白水平呈负相关(aOR 0.72,95%CI 0.54-0.95)。与因其他病原体导致菌血症的患者相比,皮质类固醇治疗增加了 NTS 菌血症的发生几率(aOR 5.22,95%CI 1.01-26.93)。

结论

在儿童中,NTS 菌血症可能在其之前的急诊就诊时就已存在。高合并症负担增加了成人沙门氏菌感染发生菌血症的几率,而血红蛋白水平可能具有保护作用。

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