Bussy Malgrange V, Bajolet Laudinat O, Gerdeaux M, Laplatte G, Mulin B, Reveil J C, Gayet S
Service de Microbiologie et Hygiène Hospitalière, Institut Jean Godinot, Reims, France.
Pathol Biol (Paris). 1998 Jun;46(6):403-7.
Bacteremia occurs frequently among critically ill patients. The aim of this study carried out in Eastern France was to describe the epidemiology of nosocomial bacteremia and to assess the methicillin-resistance of Staphylococcus aureus (SA). Data were collected during a 4 months prospective survey (09/96-12/96) carried out among 44 hospitals. We counted 2633 episodes of bacteremia classified as contamination (684), nosocomial bacteremia (970) and community bacteremia (979). Incidence rate of nosocomial bacteremia was 30.7 per 100 beds in the intensive care units. When documented, the origin of the nosocomial bacteremia was the most often catheter blood related infection or urinary tract infection. Gram positif cocci were predominant among nosocomial bacteremia (53.8%). Among Gram negative bacteria (enterobacteria) (31.6%), Escherichia coli was the most frequently isolated. SA was methicillin-resistant in 18.3% of community bacteremia and in 26.5% of nosocomial bacteremia. Coagulase negative Staphylococcus were methicillin-resistant in 25.4% of community bacteremia and in 60.1% of nosocomial bacteremia. Measures to prevent catheter blood related infections and urinary tract infections may be started.
菌血症在重症患者中频繁发生。在法国东部开展的这项研究旨在描述医院获得性菌血症的流行病学情况，并评估金黄色葡萄球菌（SA）的耐甲氧西林情况。数据收集于在44家医院开展的为期4个月的前瞻性调查期间（1996年9月 - 1996年12月）。我们统计了2633例菌血症发作，分为污染（684例）、医院获得性菌血症（970例）和社区菌血症（979例）。重症监护病房中医院获得性菌血症的发病率为每100张床位30.7例。当有记录时，医院获得性菌血症的来源最常见的是导管相关血行感染或尿路感染。革兰氏阳性球菌在医院获得性菌血症中占主导（53.8%）。在革兰氏阴性菌（肠杆菌）中（31.6%），大肠埃希菌是最常分离出的菌种。在18.3%的社区菌血症和26.5%的医院获得性菌血症中，SA对甲氧西林耐药。凝固酶阴性葡萄球菌在25.4%的社区菌血症和60.1%的医院获得性菌血症中对甲氧西林耐药。可以开始采取预防导管相关血行感染和尿路感染的措施。
