Emerg Infect Dis. 2024 Sep;30(9):1770-1778. doi: 10.3201/eid3009.240278.
We conducted a prospective study of 159 cases of subspecies (SDSE) bacteremia in 157 patients at 2 hospitals in Finland during November 2015–November 2019. Cellulitis was associated with nonsevere disease (p = 0.008); necrotizing fasciitis was associated with severe disease (p = 0.004). Fifty percent of patients had 1 clinical characteristic associated with risk for death. The case-fatality rate was 6%, and 7% of patients were treated in an intensive care unit. Blood leukocyte counts on days 2 (p = 0.032) and 3 (p = 0.020) and C-reactive protein levels on days 3 (p = 0.030) and 4 (p = 0.009) after admission were predictors of severe disease. The Pitt bacteremia score was an accurate predictor of death. Using the Pitt bacteremia score, leukocyte counts, and CRP responses during initial treatment can improve treatment strategies and survival for patients with SDSE.
我们在芬兰的 2 家医院进行了一项前瞻性研究，纳入了 2015 年 11 月至 2019 年 11 月期间 157 名患者的 159 例亚种（SDSE）菌血症病例。蜂窝织炎与非严重疾病相关（p = 0.008）；坏死性筋膜炎与严重疾病相关（p = 0.004）。50%的患者有 1 种与死亡风险相关的临床特征。病死率为 6%，7%的患者在重症监护病房接受治疗。入院后第 2 天（p = 0.032）和第 3 天（p = 0.020）的白细胞计数和入院后第 3 天（p = 0.030）和第 4 天（p = 0.009）的 C 反应蛋白水平是严重疾病的预测因素。皮特大肠杆菌败血症评分是死亡的准确预测指标。使用皮特大肠杆菌败血症评分、白细胞计数和初始治疗期间的 CRP 反应可以改善 SDSE 患者的治疗策略和生存率。
