Lockey E, Gonzalez-Lavin L, Ray I, Chen R
Thorax. 1973 Mar;28(2):183-7. doi: 10.1136/thx.28.2.183.
We have analysed the bacteraemias occurring before discharge from hospital in patients subjected to open-heart surgery. The overall incidence was 2·7%. The predominant organisms at first were staphylococci and streptococci, but in the later years of the study almost all positive blood cultures were due to Gram-negative bacilli. Short-term prophylactic antibiotics were used throughout. Eleven of the 12 Gram-positive bacteraemias occurred after the period of antibiotic prophylaxis; eight of the patients had endocarditis and a further three had serious wound infections. Most of the 32 Gram-negative bacillaemias occurred while antibiotics were being given. Some were transient phenomena in well patients; others were associated with terminal states. Infection was a major cause of death in four patients, however, and two patients had endocarditis. Serratia, providence, hafnia, and citrobacter were all identified as well as the more usual escherichia, klebsiella, and pseudomonas. We discuss the possible origins and management of these bacteraemias.
我们分析了接受心脏直视手术患者在出院前发生的菌血症情况。总体发病率为2.7%。起初，主要的病原体是葡萄球菌和链球菌，但在研究的后期，几乎所有阳性血培养结果都归因于革兰氏阴性杆菌。整个过程都使用了短期预防性抗生素。12例革兰氏阳性菌血症中有11例发生在抗生素预防期之后；其中8例患者患有心内膜炎，另有3例患者发生了严重的伤口感染。32例革兰氏阴性菌血症大多发生在使用抗生素期间。有些是病情良好患者的短暂现象；其他则与终末期状态有关。然而，感染是4例患者死亡的主要原因，2例患者患有心内膜炎。已鉴定出沙雷氏菌、普罗威登斯菌、哈夫尼亚菌和柠檬酸杆菌，以及更常见的大肠杆菌、克雷伯菌和假单胞菌。我们讨论了这些菌血症可能的来源和处理方法。
