Weinstein M P, Reller L B, Murphy J R
Diagn Microbiol Infect Dis. 1986 Sep;5(3):185-96. doi: 10.1016/0732-8893(86)90001-5.
Ninety-one episodes of polymicrobial bacteremia and fungemia were compared with 407 unimicrobial episodes to assess differences in the microbiological, epidemiological, and clinical features of the two syndromes. Enterobacteriaceae, nongroup A streptococci, anaerobic bacteria, and pseudomonads were disproportionately common in polymicrobial bacteremia. Polymicrobial episodes were significantly more likely to be hospital-acquired, to emanate from bowel or multiple foci, and to occur in patients with nonhematologic malignancies or multiple underlying diseases. Deaths directly related to sepsis were twofold higher in polymicrobial versus unimicrobial bacteremia. Factors associated with increased mortality in polymicrobial sepsis included age greater than 40 yr; absent or diminished febrile response to sepsis; absolute granulocytopenia; inadequate antimicrobial therapy for all microorganisms isolated; and a primary focus of infection in the bowel, the respiratory tract, an abscess, or an occult site. The occurrence and type of polymicrobial bacteremia can suggest a source of sepsis as well as additional diagnostic and therapeutic maneuvers.
将91例多微生物菌血症和真菌血症病例与407例单微生物菌血症病例进行比较，以评估这两种综合征在微生物学、流行病学和临床特征方面的差异。肠杆菌科细菌、非A组链球菌、厌氧菌和假单胞菌在多微生物菌血症中尤为常见。多微生物菌血症病例更有可能是医院获得性的，源自肠道或多个病灶，且发生在非血液系统恶性肿瘤或多种基础疾病患者中。与单微生物菌血症相比，多微生物菌血症中与败血症直接相关的死亡率高出两倍。多微生物败血症中与死亡率增加相关的因素包括年龄大于40岁；对败血症的发热反应缺失或减弱；绝对粒细胞减少；对所有分离出的微生物抗菌治疗不足；以及感染的主要病灶在肠道、呼吸道、脓肿或隐匿部位。多微生物菌血症的发生和类型可以提示败血症的来源以及额外的诊断和治疗手段。
