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非伤寒沙门菌血症:临床特征及危险因素

Non-typhoidal Salmonella bacteraemia: clinical features and risk factors.

作者信息

Thamlikitkul V, Dhiraputra C, Paisarnsinsup T, Chareandee C

机构信息

Department of Medicine, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand.

出版信息

Trop Med Int Health. 1996 Aug;1(4):443-8. doi: 10.1046/j.1365-3156.1996.d01-92.x.

Abstract

A case control study was conducted to determine the risk factors of non-typhoidal Salmonella bacteraemia. Eighty adult patients with non-typhoidal Salmonella bacteraemia admitted to Siriraj Hospital from January to December 1993 served as the cases. The controls comprised 3 groups: group 1, 80 adult in-patients with Escherichia coli bacteraemia; group 2, 80 adult in-patients who did not have bacteraemia and had been admitted to the hospital during the same period as the cases; group 3, 80 in-patients who did not have Salmonella bacteraemia and matched the cases in terms of gender, age, hospital services and admission date. AIDS and corticosteroid use were the major risk factors for acquiring non-typhoidal Salmonella bacteraemia with an odds ratio of 7.27 to 12.31 (95% confidence interval of 3.39 to 29.40). Almost all patients with non-typhoidal Salmonella bacteraemia presented with a fever for a median duration of 7 days. AIDS patients usually had concomitant opportunistic infections. Salmonella group D was the most common serogroup. Most patients were treated with co-trimoxazole, quinolones, ceftriaxone and ampicillin. Localized suppurative complications were observed in 14% of the patients; the overall mortality rate was 36.3%, 12% of whom died prior to receiving appropriate antibiotics for Salmonella.

摘要

开展了一项病例对照研究以确定非伤寒沙门菌菌血症的危险因素。1993年1月至12月入住诗里拉吉医院的80例成年非伤寒沙门菌菌血症患者作为病例组。对照组包括3组:第1组,80例成年大肠杆菌菌血症住院患者;第2组,80例同期住院但未发生菌血症的成年患者;第3组,80例未发生沙门菌菌血症且在性别、年龄、医院科室及入院日期方面与病例组匹配的住院患者。艾滋病和使用皮质类固醇是获得非伤寒沙门菌菌血症的主要危险因素,比值比为7.27至12.31(95%置信区间为3.39至29.40)。几乎所有非伤寒沙门菌菌血症患者均出现发热,中位持续时间为7天。艾滋病患者通常伴有机会性感染。D群沙门菌是最常见的血清群。大多数患者接受了复方新诺明、喹诺酮类、头孢曲松和氨苄西林治疗。14%的患者出现局部化脓性并发症;总死亡率为36.3%,其中12%的患者在接受针对沙门菌的适当抗生素治疗前死亡。

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