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題名 | Escherichia coli Bacteremia: A One-Year Retrospective Analysis in A University Hospital and A Community Hospital=大腸桿菌菌血症:針對某大學醫院及區域醫院一年病例的回溯分析 |
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作者 | 盧進德; 張上淳; 陳宜君; 陸坤泰; 謝維銓; Lu, Daniel C. T.; Chang, Shan-chwen; Chen, Yee-chun; Luh, Kwen-tay; Hsieh, Wei-chuan; |
期刊 | 中華民國感染症醫學會雜誌 |
出版日期 | 19970600 |
卷期 | 8:1 1997.06[民86.06] |
頁次 | 頁35-44 |
分類號 | 415.15 |
語文 | eng |
關鍵詞 | 大腸桿菌菌血症; Escherichia coli; Bacteremia; Urinary tract; |
中文摘要 | 大腸桿菌是最常自血液培養分離出來的致病菌,本文收集並分析臺大醫院及羅東博愛醫院,在1991年一年298例的大腸桿菌菌血症病例。其中女性佔多數(62.4%),患者年齡的中位數為63歲,76.8%的患者為五十歲以上。只有約四分之一的病例是院內感染所造成的。在基本疾病方面,25.5%的病人有肝膽結石,24.5%為糖尿病患者,21.1 %是癌症病人。感染的原發部位以泌尿道佔最多,有50%;其次是膽道感染,佔18.1%。自血液培養同時培養出二種細菌者,共有25例,大部份是由非泌尿道感染所引起的菌血症。在全部患者中有36人死亡,死亡率為12.1%。患者中,住在加護病房、癌症患者、肝硬化、肺炎及多菌性菌血症等均有較高的死亡率。在抗生素感受性方面,這些造成菌血症的菌株對imipenem, aztreonam,第三代cephalosporins如ceftazidime, ceftriaxone,及cefoperazone, cefotaxime,第二代cephalosporins如cefmetazole, cefamandole,及aminoglycosides如gentamicin, tobramycin, amikacin等均有不錯的感受性。但對於ampicillin及cephalothin, 則分別有63.4%及50%具抗藥性。 |
英文摘要 | Escherichia coli is the most frequently isolated species from blood cultures in most hospitals. To understand the characteristics of E. coli bacteremia, we analyzed patients from two teaching hospitals in Taiwan (National Taiwan University Hospital and Lotung PohAi Hospital) over a 12-month period. A total of 298 episodes, accounting for 24.5﹪ of the total bacteremia, occurred during the study period. The median age of the patients was 63 years, of which 76.8﹪ were 50 years old or greater. There was a female preponderance (62.4﹪) and one-fourth of the episodes were nosocomially acquired. The major underlying disease included biliary tree stone (25.5﹪), diabetes mellitus (24.5﹪), malignancy (21.1﹪) and cardiac disease (14.1﹪). Primary infectious foci were identified in 258 episodes (86.6﹪). Urinary tract was the most common portal of entry (50.0﹪) followed by the biliary tract (18.1﹪ ). Twenty-five patients (8.4﹪) had polymicrobial bacteremia, with most (24/25) originating from non-urinary tract foci. The overall case fatality rate was 12.1﹪. Patients staying in intensive care units (ICU), had underlying diseases of malignancy or liver cirrhosis, and patients with the primary focus being the respiratory tract or polymicrobial bacteremia had a poor prognosis. Most isolated strains were susceptible to imipenem (100﹪), aztreonam (99.4﹪), ceftazidime (99.4﹪), ceftriaxone (96.9﹪), cefoperazone (86.1﹪), cefmetazole (97.9﹪), cefamandole (85.1﹪), gentamicin (90.1﹪),tobramycin (88.7﹪) and amikacin (96.3﹪). More than half of the isolates were resistant to ampicillin (63.4﹪) and cephalothin (50﹪). The isolates from patients with nosocomial acquired bacteremia did not show higher resistant rates to antimicrobial agents. |
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