Caperna J, Barber R E, Toerner J G, Mathews W C
Department of Medicine, UCSD Medical Center, San Diego, CA 92103-8681, USA.
Epidemiol Infect. 1998 Feb;120(1):71-80. doi: 10.1017/s095026889700842x.
A retrospective cohort study was conducted to quantitate the relationship between neutropenia and rates of clinical bacteraemia among adults with HIV infection receiving medical care at one institution between 1991-5. The primary exposure, absolute neutrophil count (ANC), was summarized as mean ANC within a given week, using a five-level stratification (reference > 1000/microl). ANC stratum-specific rates of bacteraemia were calculated, by organism type. Linear trend tests were performed to assess dose-response relationship between neutropenia and rates of bacteraemia. The cohort included 1645 patients contributing 26,785 patients-weeks and 191 episodes of bacteraemia. The unadjusted effect of neutropenia was most evident for bacteraemia due to E. coli (RR 3.4), Klebsiella pneumoniae (RR 16.7), and P. aeruginosa (RR 10.4). For bacteraemia due to any of these three organisms (47 episodes), with reference ANC > 1000/microl, relative rates were: 751-1000/microl, 1.12; 501-750/microl, 2.11; 251-500/microl, 13.58; 0-250/microl, 21.89.
开展了一项回顾性队列研究，以量化1991年至1995年期间在某机构接受医疗护理的成人艾滋病毒感染者中性粒细胞减少与临床菌血症发生率之间的关系。主要暴露因素为绝对中性粒细胞计数（ANC），通过五级分层（参考值>1000/微升）将其总结为给定一周内的平均ANC。按病原体类型计算了ANC分层特异性菌血症发生率。进行线性趋势检验以评估中性粒细胞减少与菌血症发生率之间的剂量反应关系。该队列包括1645名患者，贡献了26785患者周，以及191例菌血症发作。中性粒细胞减少的未调整效应在由大肠杆菌（RR 3.4）、肺炎克雷伯菌（RR 16.7）和铜绿假单胞菌（RR 10.4）引起的菌血症中最为明显。对于由这三种病原体中的任何一种引起的菌血症（47例），参考ANC>1000/微升时，相对发生率分别为：751 - 1000/微升，1.12；501 - 750/微升，2.11；251 - 500/微升，13.58；0 - 250/微升，21.89。
