DeClerck Y, DeClerck D, Rivard G E, Benoit P
Can Med Assoc J. 1978 Jun 24;118(12):1523-6.
A review of the hospital records of 164 children with leukemia diagnosed between January 1969 and December 1975 disclosed 51 episodes of septicemia in 43 patients; 57 infectious agents were isolated. Gram-positive bacteria were isolated as frequently as gram-negative bacteria, each type accounting for 45.6% of all the agents isolated. Only 2 of the 24 episodes of exclusively gram-positive septicemia were fatal, whereas 9 of the 23 episodes of exclusively gram-negative septicemia were fatal. The mean duration of neutropenia was 5.6 days in patients with gram-positive septicemia and 19.5 days in patients with gram-negative septicemia, a significant difference (P less than 0.01). Gram-positive septicemia was diagnosed after a mean of 5.9 days of hospitalization and gram-negative septicemia after a mean of 29.0 days, also a significant difference (P less than 0.001). In this exclusively pediatric population of leukemic patients gram-positive agents have to be considered as potential pathogens, and initial antibiotic therapy must be selected with this fact in mind.
回顾1969年1月至1975年12月期间确诊的164例白血病患儿的医院记录，发现43例患者发生了51次败血症；分离出57种感染病原体。革兰氏阳性菌和革兰氏阴性菌的分离频率相同，每种类型占所有分离病原体的45.6%。在24次单纯革兰氏阳性菌败血症中，只有2例致命，而在23次单纯革兰氏阴性菌败血症中，有9例致命。革兰氏阳性菌败血症患者的中性粒细胞减少平均持续时间为5.6天，革兰氏阴性菌败血症患者为19.5天，差异有统计学意义（P<0.01）。革兰氏阳性菌败血症在住院平均5.9天后被诊断，革兰氏阴性菌败血症在住院平均29.0天后被诊断，差异也有统计学意义（P<0.001）。在这个单纯的白血病患儿群体中，革兰氏阳性菌必须被视为潜在病原体，初始抗生素治疗必须考虑到这一事实来选择。
