成人A组和B组β溶血性链球菌引起的菌血症

[Bacteremia caused by group A and B beta-hemolytic Streptococcus in adults].

作者信息

Ramos J M, Fernández-Roblas R, Núñez A, Fernández-Guerrero M L, Soriano F

机构信息

Departamento de Microbiología Médica, Fundación Jiménez Díaz, Madrid.

出版信息

Rev Clin Esp. 1995 Aug;195(8):541-5.

PMID:7569200

Abstract

In order to know the epidemiological, clinical and evolutive characteristics of bacteriemia caused by beta-hemolytic streptococci groups A and B, a retrospective investigation was undertaken of 48 bacteremic episodes observed in adult patients for 10 years (1985-1994). Twenty-two episodes were caused by Group A beta-hemolytic streptococci (GAS) and 26 by Group B beta-hemolytic streptococci (GBS). Patients with GAS bacteremia (GASB) had a lower mean age than patients with GBS bacteremia (GBSB) (p = 0.03). Infection with immunodeficiency virus was more common in patients with GASB than in patients with GBSBA (27 and 4%, respectively; p = 0.04); in contrast, diabetes mellitus was more common in patients with GBSB than in patients with GASB (27 and 5%, respectively) (p = 0.04). Nine (41%) patients with GBSB were i.v. drug abusers; nevertheless, none of the subjects with GBSB were i.v. drug abusers (p < 0.001). The proportion of bacteremia without demonstrable source due to GBS (41%) was significantly higher than that due to GAS (9%) (p = 0.02). Five (23%) patients with GASB and other five (20%) patients with GBSB had fatal outcomes, but only in two (9%) and three (12%) cases, respectively, was death directly attributed to bacteremia. In conclusion, bacteremias caused by GAS and GBS have different epidemiological characteristics but similar prognosis.

摘要

为了解 A 组和 B 组β溶血性链球菌引起的菌血症的流行病学、临床及演变特征，对 10 年（1985 - 1994 年）间在成年患者中观察到的 48 例菌血症发作进行了回顾性调查。22 例发作由 A 组β溶血性链球菌（GAS）引起，26 例由 B 组β溶血性链球菌（GBS）引起。GAS 菌血症（GASB）患者的平均年龄低于 GBS 菌血症（GBSB）患者（p = 0.03）。免疫缺陷病毒感染在 GASB 患者中比在 GBSBA 患者中更常见（分别为 27%和 4%；p = 0.04）；相反，糖尿病在 GBSB 患者中比在 GASB 患者中更常见（分别为 27%和 5%）（p = 0.04）。9 例（41%）GBSB 患者为静脉吸毒者；然而，GASB 患者中无一为静脉吸毒者（p < 0.001）。GBS 所致无明显来源菌血症的比例（41%）显著高于 GAS 所致（9%）（p = 0.02）。5 例（23%）GASB 患者和 5 例（20%）GBSB 患者有致命结局，但分别只有 2 例（9%）和 3 例（12%）的死亡直接归因于菌血症。总之，GAS 和 GBS 引起的菌血症有不同的流行病学特征，但预后相似。