Hoa N T, Diep T S, Wain J, Parry C M, Hien T T, Smith M D, Walsh A L, White N J
Centre for Tropical Diseases, Cho Quan Hospital, Ho Chi Minh City, Viet Nam.
Trans R Soc Trop Med Hyg. 1998 Sep-Oct;92(5):503-8. doi: 10.1016/s0035-9203(98)90891-4.
In a prospective study conducted between mid 1993 and 1994, 437 adults and children were admitted with community-acquired septicaemia to an infectious diseases hospital in southern Viet Nam. Gram-negative aerobes accounted for 90% of isolates and were predominantly Salmonella typhi (67%), Sal. para-typhi A (3%), Escherichia coli (10%), and Klebsiella spp. (5%). Other Salmonella spp. (1%), Pseudomonas aeruginosa (1%), Neisseria meningitidis (0.5%) and Haemophilus influenzae (0.2%) were uncommon. Staphylococcus aureus (5.5%) and Streptococcus pneumoniae (2%) were the most common Gram-positive isolates. Patients with enteric fever were younger (median age 16 years, range 1-63) than the other patients (median age 43 years, range 1-88) (P < 0.001) and had a lower mortality rate (0.3% vs. 23%; relative risk 69.5, 95% confidence interval 9.5-507.8; P < 0.0001). Over 70% of the Sal. typhi isolated were multi-drug-resistant, and 4% were resistant to nalidixic acid. Multidrug-resistant Sal. typhi is a major cause of community-acquired septicaemia in Viet Nam.
在1993年年中至1994年期间进行的一项前瞻性研究中，437名成人和儿童因社区获得性败血症被收治到越南南部的一家传染病医院。革兰氏阴性需氧菌占分离菌株的90%，主要是伤寒沙门氏菌（67%）、甲型副伤寒沙门氏菌（3%）、大肠杆菌（10%）和克雷伯氏菌属（5%）。其他沙门氏菌属（1%）、铜绿假单胞菌（1%）、脑膜炎奈瑟菌（0.5%）和流感嗜血杆菌（0.2%）较为少见。金黄色葡萄球菌（5.5%）和肺炎链球菌（2%）是最常见的革兰氏阳性分离菌株。伤寒热患者比其他患者年轻（中位年龄16岁，范围1 - 63岁）（其他患者中位年龄43岁，范围1 - 88岁）（P < 0.001），死亡率较低（0.3%对23%；相对风险69.5，95%置信区间9.5 - 507.8；P < 0.0001）。分离出的伤寒沙门氏菌中超过70%对多种药物耐药，4%对萘啶酸耐药。多重耐药的伤寒沙门氏菌是越南社区获得性败血症的主要原因。
