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頁籤選單縮合
| 題 名 | Bacteremia in Patients with Hematologic Malignancies=血液惡性質瘤病人之菌血症治療 |
|---|---|
| 作 者 | 王復德; 劉英明; 劉正義; | 書刊名 | 臺灣醫學會雜誌 |
| 卷 期 | 97:6 1998.06[民87.06] |
| 頁 次 | 頁405-409 |
| 分類號 | 415.6 |
| 關鍵詞 | 血液惡性質瘤病人; 菌血症; Bacteremia; Hematologic malignancy; Agar dilution method; |
| 語 文 | 英文(English) |
| 英文摘要 | The decision regarding the appropriate empirical antibiotic therapy for bacteremia in patients with hematologic malignancies must be individualized in each institution, by taking into account variations in the patterns of microbial isolates and their resistance profiles. Microbial isolates and antibiotic resistance patterns must be taken into account at each hospital. A shift from bacteremia due to infections caused by predominantly gram-negative organisms to predominantly gram-positive organisms in patients with hematologic malignancies has been noted in reports from other countries. We investigated bacterial isolates and their antibiotic sensitivities in patients with hematologic malignancies in the Veterans General Hospital-Taipei. A total of 185 episodes of bacteremia in 140 patients with hematologic malignancies were recorded during the period from 1995 to 1996. Unlike foreign reports, our investigation shows that gram-negative organisms still predominate, accounting for 72.7% of isolates, followed by gram-positive organisms, accounting for 26.3% of isolates, and anaerobes, accounting for 1% of isolates. Escherichia was the most commonly isolated organism, accounting for 23.9% of isolates, followed by Klebsiella pneumoniae (18.5%), Pseudomonas aeruginosa (12.2%), Enterobacter cloacae (7.3%), and methicillin-resistant Staphylococcus aureus (7.3%). A high mortality rate was observed in gram-negative bacteremia: 31% for E. coli, 26% for K. pneumoniae, 24% for P. aeruginosa, and 33% for E. cloacae. If methicillin-resistant S. aureus bacteremia occurred, mortality was high (47%). The antibiotic sensitivity profiles of the four most common gram-negative isolates (F. coli, K pneumoniae, P. aeruginosa, and E. cloacae indicated that, in our hospital, amikacin with either cefoperazone, ceftazidime, ciprofloxacin, or imipenem, would be an ideal combination for empirical therapy for bacteremia in patients with hematologic malignancies. |
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