Bodey G P, Jadeja L, Elting L
Arch Intern Med. 1985 Sep;145(9):1621-9. doi: 10.1001/archinte.145.9.1621.
We reviewed 410 episodes of Pseudomonas bacteremia occurring in patients with cancer during a ten-year period. Pseudomonas bacteremia was most common among patients with acute leukemia. The majority of patients acquired their infections in the hospital, and 51% had received antibiotic therapy for other presumed or proved infection during the preceding week. Shock occurred in 33%, and 32% had concomitant pneumonia. The overall cure rate was 62%; it was 67% for patients receiving appropriate antibiotics but only 14% for those receiving inappropriate antibiotics. A one- to two-day delay in the administration of appropriate antibiotic therapy reduced the cure rate from 74% to 46%. Patients who received an antipseudomonal beta-lactam antibiotic with or without an aminoglycoside had a significantly higher cure rate than patients who received only an aminoglycoside (72% and 71% vs 29%). Patients with shock, pneumonia, or persistent neutropenia had a substantially poorer prognosis.
我们回顾了十年间癌症患者发生的410例假单胞菌血症病例。假单胞菌血症在急性白血病患者中最为常见。大多数患者在医院获得感染，51%的患者在前一周因其他推测或已证实的感染接受了抗生素治疗。33%的患者发生休克，32%的患者并发肺炎。总体治愈率为62%；接受适当抗生素治疗的患者治愈率为67%，而接受不适当抗生素治疗的患者治愈率仅为14%。适当抗生素治疗延迟一至两天会使治愈率从74%降至46%。接受抗假单胞菌β-内酰胺抗生素（无论是否联合氨基糖苷类抗生素）治疗的患者治愈率显著高于仅接受氨基糖苷类抗生素治疗的患者（72%和71%对比29%）。发生休克、肺炎或持续中性粒细胞减少的患者预后明显较差。
