Bisbe J, Gatell J M, Puig J, Mallolas J, Martinez J A, Jimenez de Anta M T, Soriano E
Infectious Diseases Unit, Hospital Clinic, Faculty of Medicine, Barcelona, Spain.
Rev Infect Dis. 1988 May-Jun;10(3):629-35. doi: 10.1093/clinids/10.3.629.
One hundred thirty-three consecutive episodes of Pseudomonas aeruginosa bacteremia were prospectively followed in a university hospital over a 36-month period. The attack rate was 1.8 episodes per 1,000 discharges, and 85% of the episodes were hospital acquired. P. aeruginosa bacteremia represented 13.6% and 25.6% of the episodes of nosocomial bacteremia and gram-negative nosocomial bacteremia, respectively. The crude mortality rate was 50%. A stepwise logistic regression analysis defined four variables as independently influencing the outcome: development of septic shock (P = .00002), a granulocyte count less than 500/mm3 (P = .0008), inappropriate antibiotic therapy (P = .001), and the development of septic metastasis (P = .003). Among them, only the antibiotic treatment is easily amenable to medical intervention in order to improve the prognosis. Consequently, major efforts should focus on prevention and on the development of other therapeutic measures apart from antibiotic treatment.
在一所大学医院中，对连续133例铜绿假单胞菌血症病例进行了为期36个月的前瞻性随访。发病率为每1000例出院患者中有1.8例发病，其中85%的病例为医院获得性感染。铜绿假单胞菌血症分别占医院内菌血症和革兰阴性医院内菌血症病例的13.6%和25.6%。粗死亡率为50%。逐步逻辑回归分析确定了四个独立影响预后的变量：感染性休克的发生（P = .00002）、粒细胞计数低于500/mm3（P = .0008）、不适当的抗生素治疗（P = .001）以及感染性转移的发生（P = .003）。其中，只有抗生素治疗易于通过医学干预来改善预后。因此，主要努力应集中在预防以及开发除抗生素治疗之外的其他治疗措施上。
