Scevola D, Barbarini G, Concia E, Michelone G, Imò V
Boll Ist Sieroter Milan. 1985;64(5):376-80.
Type and number of specific diagnostic procedures; type, time and exitus of therapy were studied in the management of 335 hospitalized patients with Salmonella infection during a nine/years period (1976-1984). Sixty-three cases of S. typhi (18.8%), 26 of S. paratyphi B (7.7%), 48 of S. typhimurium (14.3%) and 198 other Salmonella species (59.1%) were identified. Positive cultures were obtained from blood in 18.8% of cases. In typhoid fever bacteriemia was detected in 60.3% of cases. The sensitivity of microorganisms to antibiotics was detected. Of 281 (83.8%) patients treated with "major" antibiotics (CAF, Ampicillin or Co-trimoxazole) clearance of Salmonella was obtained in 171 (60.8%). Stool "acidification" with lactulose was attempted in 54 patients (16.2%), of which 20 (37%) became negative. Charges of the bacteriologic cultures, serological tests, antibiotics and supportive therapy were estimated in order to assess the cost/benefit ratio of patients care. Length of stay and chemotherapy were respectively 20.7 (11-18) and 11 (7-17) days. Maximal cost/case ratio occurs in diagnosis for stool cultures, in therapy for Ampicillin. The introduction of an economic approach to use diagnostic and therapeutic procedures has significantly improved the management of Salmonella infections from 1976 to 1984.
在9年期间（1976 - 1984年），对335例住院沙门氏菌感染患者的治疗情况进行了研究，包括特定诊断程序的类型和数量、治疗的类型、时间及结果。共鉴定出63例伤寒沙门氏菌（18.8%）、26例副伤寒乙沙门氏菌（7.7%）、48例鼠伤寒沙门氏菌（14.3%）和198例其他沙门氏菌属（59.1%）。18.8%的病例血培养呈阳性。伤寒热患者中60.3%检测到菌血症。检测了微生物对抗生素的敏感性。在281例（83.8%）接受“主要”抗生素（头孢呋辛、氨苄西林或复方新诺明）治疗的患者中，171例（60.8%）沙门氏菌清除。对54例患者（16.2%）尝试用乳果糖进行粪便“酸化”，其中20例（37%）转阴。估算了细菌培养、血清学检测、抗生素及支持治疗的费用，以评估患者护理的成本效益比。住院时间和化疗时间分别为20.7（11 - 18）天和11（7 - 17）天。粪便培养诊断及氨苄西林治疗的成本/病例比值最高。从1976年到1984年，采用经济方法应用诊断和治疗程序显著改善了沙门氏菌感染的治疗。
