Wächter Hannah, Yörük Erdal, Becker Karsten, Görlich Dennis, Kahl Barbara C
Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany.
Friedrich Loeffler-Institute of Medical Microbiology, University Medicine Greifswald, 17475 Greifswald, Germany.
J Clin Med. 2021 Mar 28;10(7):1371. doi: 10.3390/jcm10071371.
bacteremia (SAB) is a frequent, severe condition that occurs in patients of all age groups and affects clinical departments of all medical fields. It is associated with a high mortality rate of 20-30%. In this study, we analyzed patient mortality associated with SAB at our tertiary care university hospital, assessed the clinical management in terms of administered antimicrobial therapy, and determined which factors have an impact on the clinical course and outcome of patients with this disease. We collected clinical data and blood culture isolates of 178 patients diagnosed with SAB between May 2013 and July 2015. For this study, bacteria were cultured and analyzed concerning their phenotype, hemolysis activity, biofilm formation, nuclease activity, prevalence of toxin genes, and type. Overall mortality was 24.2% and 30-day mortality was 14.6%. Inadequate initial therapy was administered to 26.2% of patients and was associated with decreased survival ( = 0.041). Other factors associated with poor survival were patient age ( = 0.003), type 4 ( ≤ 0.001) and pathological leukocyte counts ( = 0.029 if elevated and = 0.003 if lowered). The type of infection focus, clonal complex and enterotoxin genes and had an impact on severity of inflammation. Our results indicate that mortality and burden of disease posed by SAB are high at our university hospital.
血流感染(SAB)是一种常见的严重病症,发生于所有年龄组的患者,影响所有医学领域的临床科室。它与20% - 30%的高死亡率相关。在本研究中,我们分析了我校三级医疗大学医院中与SAB相关的患者死亡率,评估了抗菌治疗方面的临床管理,并确定了哪些因素对该病患者的临床病程和结局有影响。我们收集了2013年5月至2015年7月期间178例诊断为SAB患者的临床数据和血培养分离株。对于本研究,对细菌进行培养并分析其表型、溶血活性、生物膜形成、核酸酶活性、毒素基因流行情况及类型。总死亡率为24.2%,30天死亡率为14.6%。26.2%的患者接受了不充分的初始治疗,且与生存率降低相关(P = 0.041)。与生存不良相关的其他因素包括患者年龄(P = 0.003)、4型(P≤0.001)和病理性白细胞计数(升高时P = 0.029,降低时P = 0.003)。感染灶类型、克隆复合体及肠毒素基因A和B对炎症严重程度有影响。我们的结果表明,我校大学医院中SAB造成的死亡率和疾病负担很高。