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題名 | 院內感染之Klebsiella Pneumoniae菌血症=Nosocomial Klebsiella Pneumoniae Bacteremia |
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作者 | 胡伯賢; 劉有增; 施智源; 林育蕙; Hu, Bor-shen; Lau, Yeu-jun; Shi, Zhi-yuan; Lin, Yu-hui; |
期刊 | 院內感染控制雜誌 |
出版日期 | 19971000 |
卷期 | 7:5 1997.10[民86.10] |
頁次 | 頁286-292 |
分類號 | 419.38 |
語文 | chi |
關鍵詞 | 菌血症; 院內感染; Klebsiella pneumoniae; Bacteremia; Nosocomial infection; |
中文摘要 | 在臺灣Klebsiella pneumoniae菌種不但是社區感染常貝的致病菌,亦是很重要的院內感染病原。它是院內感染革蘭氏陰性桿菌的重要成員之一。1995年於某醫學中心,此病菌躍升為所有院內感染菌血症之第二名。從1993年1月至1994年12月止,我們有86人計88次院內感染K. pneumoniae菌血症之個案。年齡分佈從新生兒到八十六歲,介於六十歲者有34人次,介於六十歲到四十一歲者有20人次,四十歲到十五歲者有11人次,十四歲到一歲者有2人次,小於一歲者有21人次。男女之比為3比1。其中39人次為內科患者。侵入的途徑依序為呼吸道,導管感染,腸胃道,腹腔和泌尿道。癌症是最常合併之原發性疾病,神經疾病次之,再其次是糖尿病,肝膽疾病。總體的死亡率為47.7﹪。預後較差之因子為休克,以腹腔為侵入途徑,散播性血管內凝固,血小板減少,及大於四十歲以上的患者。 |
英文摘要 | In Taiwan, Klebsiella pneumoniae is not only a common pathogen in community-acquired infections, but also a frequent cause of nosocomial infections. It is one of the most important gram-negative nosocomial pathogens. This microorganism is the second most common cause of nosocomial bacteremia at a medical center in 1995. During the period between January, 1993 through December 1994, we had 86 patients with 88 episodes of nosocomial K. pneumoniae bacteremia. Their age ranged from newborn to 86 years: 34 were older than 60 years, 20 were 41 to 60 years, 11 were 15 to 40 years, 2 were 1 to 14 years, and 21 were younger than 1 year. The proportion of male and female was 3:1. Thirty-nine of our patients acquired K. pneumoniae bacteremia in adult medical units. The most frequent clinical findings were fever, thrombocytopenia and leukocytosis, in decreasing order. The portals of entry, in decreasing order of frequency, were respiratory tract, sites of catheter insertion, gastrointestinal tract, abdominal cavity, and urinary tract. Malignancy was the most common underlying disease, following by neurological diseases, diabetes mellitus, and hepatobiliary diseases. Overall mortality for our episodes was 47.7%. The poor prognostic factors were the presence of shock, the abdominal cavity as the portal of entry, the appearance of disseminated intravascular coagulation, thrombocytopenia, and being older than 40 years of age. |
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