Elgefors B, Olling S
Scand J Infect Dis. 1978;10(3):203-7. doi: 10.3109/inf.1978.10.issue-3.08.
Clinical findings from 76 patients (median age 67 years) with gram-negative bacteremia were analysed and related to the sensitivity of the blood isolates to the bactericidal activity of normal human serum. 28 strains (37%) were resistant, an equal number intermediately sensitive and 20 markedly sensitive (26%). No correlation was found between serum sensitivity and origin of the bacteremia, presence of fever or blood granulocyte count. The frequency of shock in immunocompromised patients with serum-resistant strains was 60% (6/10); in those with intermediately or markedly sensitive strains it was 44% (8/18). In the non-immunocompromised patients with resistant strains the frequency of shock was 33 (6/18) versus 10% (3/30) in those without such strains. Thus the risk of developing shock with gram-negative bacteremia seems to depend on both parasite and host factors, although in this study only the latter were statistically significant. We conclude that serum-sensitive strains can invade the blood stream in spite of the serum bactericidal activity and cause severe disease in some patients.
对76例革兰氏阴性菌血症患者（中位年龄67岁）的临床发现进行了分析，并将其与血液分离株对正常人血清杀菌活性的敏感性相关联。28株（37%）耐药，同等数量为中度敏感，20株高度敏感（26%）。未发现血清敏感性与菌血症的来源、发热的存在或血液粒细胞计数之间存在相关性。免疫功能低下且感染血清耐药菌株的患者发生休克的频率为60%（6/10）；感染中度或高度敏感菌株的患者为44%（8/18）。在非免疫功能低下且感染耐药菌株的患者中，休克的频率为33%（6/18），而未感染此类菌株的患者为10%（3/30）。因此，革兰氏阴性菌血症发生休克的风险似乎取决于寄生虫和宿主因素，尽管在本研究中只有后者具有统计学意义。我们得出结论，血清敏感菌株尽管存在血清杀菌活性，但仍可侵入血流并在一些患者中引起严重疾病。
