Fry D E, Fry R V, Shlaes D M
Am Surg. 1987 Aug;53(8):438-41.
A 42-month review has identified 32 surgical patients that had 45 episodes of Serratia marcescens bacteremia. Patients were identified in many surgical specialties. The primary focuses of infection were the urinary tract, intravascular devices, sputum, and soft tissue. In five patients, no focus was identifiable. Nine patients had polymicrobial sepsis with other bacteria or Candida. Of 41 isolates studied, five were resistant to all antibiotics that were commercially available. Only 76 per cent were sensitive to amikacin, 63 per cent to gentamicin, and 46 per cent to tobramycin. Statistically fewer patients died when an aminoglycoside and an expanded-spectrum penicillin were used in combination. The 44 per cent mortality rate of this group of patients indicates that environmental control, behavioral modification of health care professionals, and a more rationale use of broad-spectrum antibiotics are necessary to prevent this morbid complication.
一项为期42个月的回顾性研究确定了32例外科手术患者发生了45次粘质沙雷氏菌菌血症。患者来自多个外科专业领域。感染的主要部位是泌尿道、血管内装置、痰液和软组织。有5例患者未发现感染部位。9例患者发生了与其他细菌或念珠菌相关的多微生物败血症。在所研究的41株分离菌中，有5株对所有市售抗生素耐药。仅76%的菌株对阿米卡星敏感，63%对庆大霉素敏感，46%对妥布霉素敏感。统计学分析表明，联合使用氨基糖苷类抗生素和广谱青霉素时死亡患者较少。该组患者44%的死亡率表明，为预防这种严重并发症，有必要进行环境控制、改变医护人员的行为以及更合理地使用广谱抗生素。
