NOSOCOMIAL SEPTICEMIA DUE TO MULTIPLY ANTIBIOTIC-RESISTANT STAPHYLOCOCCUS-EPIDERMIDIS
NOSOCOMIAL SEPTICEMIA DUE TO MULTIPLY ANTIBIOTIC-RESISTANT STAPHYLOCOCCUS-EPIDERMIDIS
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DOI：
10.7326/0003-4819-96-1-1
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发表时间：
1982-01-01
影响因子：
39.2
通讯作者：
LUTHER, RW
中科院分区：
文献类型：
--
作者：
CHRISTENSEN, GD;BISNO, AL;LUTHER, RW
20个月内发生13次表皮葡萄球菌败血症。期间有11名患者接受普通外科和内科护理。这些发作的特点是发热、毒性、多种阳性血培养和均匀定植的血管内导管。另有16名患者可能有脓毒症。发生了4例相关死亡；所有3名尸检的患者都有多发性肺脓肿，其中大量存在革兰阳性球菌。在个别患者中，多种表皮葡萄球菌血培养分离株在抗生素耐药模式、噬菌体类型和生物型上相同，证实了持续的败血症发作。表皮葡萄球菌分离株的一个显著特征是对许多常用的抗菌剂具有耐药性。病例对照研究和实验室记录回顾表明，多重耐药表皮葡萄球菌血液分离株与长期住院和肠外高营养显著相关。这些患者大多是在重症监护室住院；从工作人员的鼻子和手培养结果显示，经常携带多重耐药表皮葡萄球菌。与血管内装置相关的表皮葡萄球菌可能会产生危及生命的血液感染。
Thirteen episodes of S. epidermidis sepsis occurred over a 20 mo. period in 11 patients receiving general surgical and medical care. These episodes were characterized by fever, toxicity, multiple positive blood cultures and uniformly colonized intravascular catheters. An additional 16 patients had possible sepsis. Four associated deaths occurred; all 3 patients autopsied had multiple pulmonary abscesses in which gram-positive cocci were profusely present. In individual patients, prolonged episodes of septicemia were confirmed by multiple blood culture isolates of S. epidermidis, identical in antibiotic resistance pattern, phage type and biotype. A prominent feature of the S. epidermidis isolates was resistance to many commonly used antimicrobial agents. Case-control studies and review of laboratory records indicated a significant association between multiply resistant S. epidermidis blood isolates and prolonged hospitalization and parenteral hyperalimentation. Most of these patients were hospitalized in the intensive care unit; nose and hand cultures taken from the personnel showed frequent carriage of multiply resistant S. epidermidis. S. epidermidis associated with intravascular devices may produce life-threatening bloodstream infections.