The Clinical Significance of Aeromonas Bacteremia in Patients with Liver Cirrhosis

單胞菌菌血症在肝硬化病人的臨床意義

李承鴻(Chern-Horng Lee) ； 張啓仁(Chee-Jen Chang) ； 邱正堂(Cheng-Tang Chiu) ； 何玉彬(Yu-Pin Ho) ； 林灯寅(Deng-Yn Lin)

《臺灣消化醫學雜誌》 24卷4期 (2007/12) Pp. 378-385

https://doi.org/10.6557/GJT.200712_24(4).0002

摘要

背景及目的：單胞菌是低致病性的革蘭氏陰性桿菌，但在肝硬化的病人感染時卻是會致命。目標是要尋找對於有肝硬化病人，合併有單胞菌菌血症時的臨床表現、危險因子及預後，與大腸桿菌菌血症比較。
方法：回溯性找尋1996年7月到1998年6月期間，血液培養單胞菌陽性個案，共有137個病例，其中有57個肝硬化病人，60人次得到該菌感染；另從血液培養大腸桿菌陽性個案，共有1182個病例，其中有115個肝硬化病人，118人次得到該菌感染。
結果：肝硬化病人，合併有單胞菌菌血症時最重要的危險因子有：多發性菌血症、合併消化道出血、敗血性休克和自發性腹膜炎。
結論：一旦發現有單胞菌菌血症時的病人，首先要考慮到是否有肝硬化；進一步找尋，並注意以上提及合併的危險因子有較高死亡率。

關鍵字

單胞菌 ； 菌血症 ； 肝硬化

並列摘要

Background: and Aims Aeromonads are low-virulence Gram-negative bacilli, but infection may be fatal for patients with decompensated liver cirrhosis. We try to investigate clinical features, risk factors, and outcome for patients with cirrhosis who developed Aeromonas bacteremia in comparison with E. coli bacteremia.
Methods: We retrospectively review 137 consecutive episodes of Aeromonas bacteremia in inpatients at our institution from July 1996 to June 1998. Of them, 60 (43.8%) developed in 57 patients with cirrhosis, 26 of them (43.3%) died. A total of 1,221 episodes of E. coli bacteremia among 1,182 patients were collected for comparative analysis. Of these, 118 (9.66%) occurred in 115 patients with cirrhosis, 33 patients (28%) died.
Results: The most important risk factors for mortality from Aeromonas bacteremia included polymicrobial infection, gastrointestinal bleeding, septic shock, and symptoms associated with spontaneous bacterial peritonitis.
Conclusions: The results indicate that, once Aeromonas bacteremia has been identified, the most common underlying disease to investigate is liver cirrhosis and high mortality in patients with high risk factors.

並列關鍵字

aeromonas ； bacteremia ； liver cirrhosis