Skerk V, Bobinac E, Popović-Uroić T, Schönwald S
Klinika za infektivne bolesti Dr. Fran Mihaljević, Zagreb.
Lijec Vjesn. 1993 Mar-Apr;115(3-4):85-9.
Clinical and laboratory features were analyzed in 277 patients with 279 episodes of E. coli bacteremia, treated at the University Hospital of Infectious Diseases "Dr Fran Mihaljević"c, Zagreb between 1980 and 1989. Patients ranged in age from 4 days to 91 years. Thirty-two per cent of patients were male and 68% were female. The majority of patients had underlying disease which was considered not to be fatal within the next five years (57%) or they were completely healthy (34%). Four per cent of bacteremias were polymicrobic and 13% were considered nosocomial in origin. The clinical source of bacteremia was known in 84%. In community-acquired bacteremia, the urinary tract was the most frequent site of origin (78%) and in nosocomial-acquired bacteremia the source could not be identified (54%). Septic shock occurred in 24% of the patients and coagulation abnormalities were observed in 41% of the patients. Fatal outcome was registered in 10% of the patients. Mortality was higher among males (16%:7%) up to 2 months of age (29%) and above 60 years (15%), and in those with nosocomial-acquired bacteremia (49%), polymicrobial (50%) and recurrent bacteremia (50%), as well as in patients with severe underlying disease (29-75%). Mortality was lower in patients who were given an early appropriate antimicrobial therapy. The advantage of combinations of antimicrobial therapies over monotherapy could not be demonstrated among patients in each category of severity of underlying host disease.
对1980年至1989年间在萨格勒布“弗兰·米哈列维奇博士”传染病大学医院接受治疗的277例患者的279次大肠杆菌菌血症发作的临床和实验室特征进行了分析。患者年龄从4天至91岁不等。32%的患者为男性，68%为女性。大多数患者患有基础疾病，这些基础疾病在未来五年内被认为不会致命（57%），或者他们完全健康（34%）。4%的菌血症为多微生物性，13%被认为起源于医院感染。84%的菌血症临床来源已知。在社区获得性菌血症中，泌尿道是最常见的起源部位（78%），而在医院获得性菌血症中，来源无法确定（54%）。24%的患者发生感染性休克，41%的患者观察到凝血异常。10%的患者出现致命结局。男性（16%:7%）、2个月以下（29%）和60岁以上（15%）、医院获得性菌血症患者（49%）、多微生物性菌血症患者（50%）、复发性菌血症患者（50%）以及患有严重基础疾病的患者（29 - 75%）的死亡率更高。接受早期适当抗菌治疗的患者死亡率较低。在基础宿主疾病严重程度的每一类患者中，无法证明联合抗菌治疗比单一治疗更具优势。
