McGregor A R, Collignon P J
Infectious Diseases Unit, Woden Valley Hospital, Garran, ACT.
Med J Aust. 1993 May 17;158(10):671-4. doi: 10.5694/j.1326-5377.1993.tb121913.x.
To obtain a comprehensive overview of bacteraemia and fungaemia in a general hospital and thus to determine the incidence, primary sites of sepsis, organisms involved and associated mortality.
A prospective laboratory and clinical evaluation of all episodes where microorganisms were cultured from blood over one year.
The two major hospitals in the Australian Capital Territory which have both community and referral functions. These hospitals provide obstetric and paediatric services along with adult medicine and surgery.
All those who acquired bacteraemia in hospital or presented with a blood-stream infection documented by a positive blood culture.
During 1990, 474 clinical episodes of bacteraemia or fungaemia were detected in 446 patients. Significant isolates were identified in 317 of these episodes. The incidence of significant sepsis was 8.1 episodes per 1000 admissions. The most common organisms isolated were Staphylococcus aureus (75 episodes) and Escherichia coli (70 episodes). One hundred and twenty-eight episodes were hospital acquired. Intravenous catheters were the primary sites of sepsis in 68 episodes. Fifty patients died. Higher mortality rates were associated with patients over 60 years of age, respiratory tract sepsis, endocarditis and the presence of an underlying malignancy.
Bacteraemia and fungaemia are common problems. Nosocomial bacteraemia accounted for 40% of episodes. Half of these nosocomial infections were iatrogenic. Many of the episodes of intravenous catheter sepsis were potentially preventable. Ongoing programs of surveillance of bacteraemia, with the evaluation of primary site, associated features and mortality, are essential to monitor the dimensions of this problem and aid in implementing effective preventive strategies.
全面了解综合医院中菌血症和真菌血症的情况，从而确定发病率、败血症的原发部位、相关微生物及相关死亡率。
对一年内所有从血液中培养出微生物的病例进行前瞻性实验室和临床评估。
澳大利亚首都地区的两家主要医院，兼具社区服务和转诊功能。这些医院提供产科、儿科服务以及成人内科和外科服务。
所有在医院获得菌血症或血培养阳性证明有血流感染的患者。
1990年期间，在446名患者中检测到474例菌血症或真菌血症临床病例。其中317例病例鉴定出重要病原菌。严重败血症的发病率为每1000例入院患者中有8.1例。分离出的最常见微生物是金黄色葡萄球菌（75例）和大肠杆菌（70例）。128例病例是医院获得性感染。68例病例中，静脉导管是败血症的主要部位。50名患者死亡。60岁以上患者、呼吸道败血症、心内膜炎以及存在潜在恶性肿瘤的患者死亡率较高。
菌血症和真菌血症是常见问题。医院获得性菌血症占病例的40%。这些医院获得性感染中有一半是医源性的。许多静脉导管败血症病例是可以预防的。持续开展菌血症监测项目，评估原发部位、相关特征和死亡率，对于监测该问题的规模以及协助实施有效的预防策略至关重要。
