查詢結果分析
相關文獻
- Nosocomial Gram-Negative Bacteremia in Critically Ill Patients: Epidemiologic Characteristics and Prognostic Factors in 147 Episodes
- 新生兒加護病房的院內感染
- 院內感染與早產兒
- 冠狀動脈繞道手術之手術部位感染危險因子之探討
- 一區域醫院1995至1997年院內感染資料分析
- 醫院內感染和空調
- Acinetobacter Baumannii院內感染之介紹
- Nosocomial Klebsiella pneumoniae Bacteremia: Clinical Features and Antimicrobial Susceptibilities of Isolates
- 某醫學中心各加護中心院內感染金黃色葡萄球菌之調查
- Acinetobacter Calcoaceticus-Baumannii Complex Bacteremia:Analysis of 82 Cases
頁籤選單縮合
題 名 | Nosocomial Gram-Negative Bacteremia in Critically Ill Patients: Epidemiologic Characteristics and Prognostic Factors in 147 Episodes=重症病患之院內感染革蘭氏陰性菌血症:147病例流行病學特徵及預後分析 |
---|---|
作 者 | 張藏能; 郭英調; 沈沈惠; 馮長風; 李淑華; 楊彩蓮; 黃建賢; | 書刊名 | 臺灣醫學會雜誌 |
卷 期 | 98:7 1999.07[民88.07] |
頁 次 | 頁465-473 |
分類號 | 415.15 |
關鍵詞 | 院內感染; 革蘭氏陰性菌血症; Bacteremia; Nosocomial; Gram-negative bacteria; Critically ill patients; Prognosis; |
語 文 | 英文(English) |
英文摘要 | Although gram-positive organisms are the most common causes of nosocomial bloodstream infections, gram-negative bacteremia carries higher risks of severe sepsis, septic shock, and death among critically ill patients in intensive care units (ICUs). We performed a prospective epidemiologic analysis of nosocomial gram- negative bacteremia episodes among ICU patients and sought to identify risk factors for mortality among these patients. All episodes of nosocomial gram-negative bacteremia documented in five ICU wards of our hospital during a 2-year period were included. There were 147 episodes (124 patients) of gram-negative bacteremia documented during the study period. The overall mortality rate was 36.1%, and 77.4% of all deaths were directly related to the bloodstream infection. Gram-negative bacteremia was associated with prolonged ICU stay (45.7 d vs 6.1 d for all ICU patients). The most common isolate was Acinetobacter baumannii, followed by Burkholderia cepacia and Enterobacter cloacae. The most frequent source of infection was the lower respiratory tract (32.0%). Of the agents tested, ciprofloxacin, imipenem, and ceftazidime were the most active against the clinical isolates. Multivariate logistic regression analysis identified the presence of septic shock (odds ratio, OR 17.66, p < 0.001) and rapidly fatal and ultimately fatal underlying conditions (OR = 3.47, p = 0.032) as being independent risk factors for mortality. Early appropriate antibiotic treatment did not result in significant improvement in survival. These findings suggest that prevention of lower respiratory tract colonization and nosocomial pneumonia are crucial for reducing the incidence of nosocomial gram-negative bacteremia in the ICU. Serious underlying illnesses and septic shock were the most important risk factors for death in these patients. |
本系統中英文摘要資訊取自各篇刊載內容。