Nejtek Tomáš, Müller Martin, Moravec Michal, Průcha Miroslav, Zazula Roman
Department of Epidemiology, Faculty of Military Science, University of Defence, 500 01 Hradec Králové, Czech Republic.
Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University and Thomayer University Hospital, 140 59 Prague, Czech Republic.
Microorganisms. 2023 Sep 20;11(9):2357. doi: 10.3390/microorganisms11092357.
Sepsis (and septic shock) is on of the most common causes of death worldwide. Bacteremia often, but not necessarily, occurs in septic patients, but the impact of true bacteremia on a patient's clinical characteristics and outcome remains unclear. The main aim of this study was to compare the characteristics and outcome of a well-defined cohort of 258 septic patients with and without bacteremia treated in the intensive care unit (ICU) of a tertiary center hospital in Prague, Czech Republic. As expected, more frequently, bacteremia was present in patients without previous antibiotic treatment. A higher proportion of bacteremia was observed in patients with infective endocarditis as well as catheter-related and soft tissue infections in contrast to respiratory sepsis. Multivariant analysis showed increased severity of clinical status and higher Charlson comorbidity index (CCI) as variables with significant influence on mortality. Bacteremia appears to be associated with higher mortality rates and length of ICU stay in comparison with nonbacteremic counterparts, but this difference did not reach statistical significance. The presence of bacteremia, apart from previous antibiotic treatment, may be related to the site of infection.
脓毒症（和脓毒性休克）是全球最常见的死亡原因之一。菌血症在脓毒症患者中经常（但并非必然）出现，但真正的菌血症对患者临床特征和预后的影响仍不明确。本研究的主要目的是比较在捷克共和国布拉格一家三级中心医院的重症监护病房（ICU）接受治疗的258例明确诊断的脓毒症患者（有菌血症和无菌血症）的特征和预后。正如预期的那样，未接受过抗生素治疗的患者中菌血症更为常见。与呼吸道脓毒症相比，感染性心内膜炎以及导管相关和软组织感染患者中菌血症的比例更高。多变量分析显示，临床状态的严重程度增加和较高的查尔森合并症指数（CCI）是对死亡率有显著影响的变量。与无菌血症的患者相比，菌血症似乎与更高的死亡率和ICU住院时间相关，但这种差异未达到统计学意义。除了先前的抗生素治疗外，菌血症的存在可能与感染部位有关。
