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IR@PKUHSC  > 北京大学第一临床医学院  > 抗感染病房  > 期刊论文
学科主题: 临床医学
题名:
成人败血症249例回顾性临床分析
其他题名: Septicemia:A Retrospective Clinical Analysis of 249 Adult Patients
作者: 马序竹; 李湘燕; 侯芳; 吕媛
关键词: 败血症 ; 病原菌 ; 耐药性 ; Septicemia ; Pathogen ; Drug resistance
刊名: 中华医院感染学杂志
发表日期: 2010
卷: 20, 期:5, 页:648-650
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 分析成人败血症的临床特点及病原菌分布、耐药性特点,为临床血流感染的防治提供依据.方法 对医院1999~2008年成人败血症249例进行回顾性临床分析.结果 患者院内感染败血症154例,占61.8%;总死亡率34.5%;最常见的临床并发症依次为恶性肿瘤、糖尿病及粒细胞缺乏;病原菌检出革兰阴性菌146株,占58.6%,革兰阳性菌82株,占32.9%,真菌占8.4%,最常见的病原菌依次为大肠埃希菌(29.7%),金黄色葡萄球菌(14.5%)和肺炎克雷伯菌(11.7%);大肠埃希菌及肺炎克雷伯菌产ESBLs率分别为43.2%和42.9%;葡萄球菌属中耐甲氧西林葡萄球菌占69.8%;亚胺培南对肠杆菌科细菌、万古霉素对革兰阳性球菌耐药率均为0.结论 成人败血症病例逐年增加,其中社区感染败血症的比例近年来有所增加;分离的病原菌耐药程度较高,但未发现耐碳青酶烯类肠杆菌科细菌及耐万古霉素革兰阳性球菌. OBJECTIVE To investigate the clinical features of adult septicemia and analyze the distribution and antibiotic resistance of the pathogenic organisms.METHODS An electronic medical records review was performed to identify adult patients from 1999 to 2008 in Peking University First Hospital.RESULTS A total of 249 unique patients were identified,154 cases were with nosocomial septicemia(61.8%)with the mortality rate 34.5%.The most frequent comorbid medical conditions were cancer,diabetes mellitus and neutropenia.Gram-negative bacteria was the main pathogenic organism(58.6%).The most common organism identified were Escherichia coli (29.7%),Staphylococcus aureus(14.5%)and Klebsiella pneumoniae(11.7%).The isolate rate of fungi was 8.4%.The rates of ESBLs-producing strains of E.coli and K.pneumoniae were 43.2%and 42.9%,respectively.69.8%of Staphylococcus strains were meticillin-resistant(MRS).The resistance rates of Enterobacter species to carbapenem and Gram-positive cocci to vancomycin were all zero.CONCLUSIONS In this study,the cases of adult septicemia are escalated by years and the community-acquired septicemia rate has sharply risen.The rate of multidrug-resistant pathogenic organisms is high,but the carbapenem-resistant Enterobacteriaceae and vancomycin-resistant Gram-positive cocci are not found.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/42533
Appears in Collections:北京大学第一临床医学院_抗感染病房_期刊论文

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作者单位: 北京大学第一医院抗感染病房,北京,100034
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