Ko W C, Chuang Y C
Department of Medicine, National Cheng Kung University Hospital, Taiwan, Republic of China.
Clin Infect Dis. 1995 May;20(5):1298-304. doi: 10.1093/clinids/20.5.1298.
Fifty-nine episodes of bacteremia due to Aeromonas species occurred within a 5-year period in one medical center in southern Taiwan. Underlying diseases in the 58 patients included hepatic cirrhosis (36%) and cancer (24%). Patients with aeromonas bacteremia more often had underlying hepatic cirrhosis than did those with bacteremia due to other gram-negative bacilli. Males (67%) outnumbered females. The cases appeared to cluster in the summer and fall months. Thirty-two percent were polymicrobial infections; often the Aeromonas pathogens were accompanied by other gram-negative bacilli. Aeromonas hydrophila was the most common species isolated (69%). In addition to fever, hypotension and jaundice were the common clinical manifestations of aeromonas sepsis. In cirrhotic patients, spontaneous bacterial peritonitis, altered mental status, and jaundice were most common, and aeromonas bacteremia in such patients was monomicrobial and community-acquired more often than in noncirrhotic patients. In vitro aeromonads were generally susceptible to aminoglycosides, cefuroxime, the third-generation cephalosporins, and quinolones. The overall crude fatality rate was 36%. Predictors of fatal outcome for cirrhotic patients included spontaneous bacterial peritonitis, hypotension on admission, diabetes mellitus, and high Pugh scores.
在台湾南部的一个医疗中心，5年期间共发生59例气单胞菌属菌血症。58例患者的基础疾病包括肝硬化（36%）和癌症（24%）。气单胞菌菌血症患者比其他革兰氏阴性杆菌菌血症患者更常伴有基础肝硬化。男性（67%）多于女性。病例似乎集中在夏季和秋季。32%为混合微生物感染；气单胞菌病原体常伴有其他革兰氏阴性杆菌。嗜水气单胞菌是最常分离出的菌种（69%）。除发热外，低血压和黄疸是气单胞菌败血症的常见临床表现。在肝硬化患者中，自发性细菌性腹膜炎、精神状态改变和黄疸最为常见，此类患者的气单胞菌菌血症比非肝硬化患者更常为单一微生物感染且为社区获得性感染。体外实验中气单胞菌通常对氨基糖苷类、头孢呋辛、第三代头孢菌素和喹诺酮类敏感。总体粗死亡率为36%。肝硬化患者死亡结局的预测因素包括自发性细菌性腹膜炎、入院时低血压、糖尿病和高普格评分。
