菌種血流感染之預後因子分析

Factors Influencing Prognosis of Blood Stream Infection

陳達人(Dar-Ren Chen) ； 林國瑞(Kuo-Juei Lin) ； 郭憲文(Hsien-Wen Kuo)

《Mid-Taiwan Journal of Medicine》 3卷2期 (1998/06) Pp. 108-114

https://doi.org/10.6558/MTJM.1998.3(2).7

摘要

作者從1992年至1995年，收集中部某醫學中心，397個菌種血流感染的病患，以回顧性的研究其預後因子的關係。據統計血液是菌類感染最大之來源，其次是尿液。其中葡萄球菌感染率最高，其次是多菌種感染及大腸桿菌。念珠球菌是最大的致命菌種，接著是綠膿桿菌及腸球菌。院內感染及社區感染的死亡率分別是32.4%及25.0%。我們使用邏輯複迴歸分析來評估影響預後的因素包括年齡，潛在性疾病，休克及抗生素之使用均是具有統計上意義的危險因子。因此我們認為具此類危險因子的病人均需特別小心評估及治療，而且醫院方面對產生院內感染因子的感染源須加以消除。

關鍵字

菌種血流感染 ； 院內感染 ； 社區感染

並列摘要

We investigated 397 episodes of bacterial stream infection that occurred from 1992 to 1995 and the factors influencing prognosis. Blood was the most common source for bacteremia followed by urine. Staphylococcus had the highest incidence rate, followed by Polymicrobial and Escherchia coli, respectively. Candida was found to be the most lethal species of bacteremia, followed by Pseudomonas and Enterococcus. The fatality rate for nosocomial infections was 32.4% and 25.0% for community-acquired infections. A logistic regression model was used to evaluate factors most likely to affect the fatality rate: Age, underlying disease, shock, and antibiotic therapy were significant risk factors. We, therefore, suggest that extra care must be taken when patients exhibit these risk factors and hospitals must strive to eliminate all sources of causative organisms that can lead to nosocomial infections.

並列關鍵字

blood stream infection ； nosocomial infection ； community acquired infection