Epidemiology and microbiology of sepsis in mainland China in the first decade of the 21st century
Epidemiology and microbiology of sepsis in mainland China in the first decade of the 21st century
复制标题
21世纪前十年中国大陆脓毒症流行病学及微生物学研究
DOI：
10.1016/j.ijid.2014.11.027
复制
发表时间：
2015-02-01
影响因子：
8.4
通讯作者：
Chen, Xin-Zu
中科院分区：
文献类型：
--
作者：
Chen, Xin-Chuan;Yang, Yun-Fan;Chen, Xin-Zu
目的：描述21世纪头10年中国大陆地区脓毒症的流行病学和微生物学特征。方法：从《中国卫生统计年鉴》中检索2003年和2007年与脓毒症相关的死亡数据。应用计算机检索中国学术期刊数据库2001年至2009年间的微生物学数据。结果：随着时间的推移，中小城市和农村地区的脓毒症死亡率明显下降。1~54岁亚群死亡率低于全国平均水平。相比之下，新生儿和老年人(75岁)的败血症死亡率明显高于全国平均水平。2003至2007年间，虽然老年人死亡率下降，但新生儿败血症死亡率急剧上升，尤其是在男婴中。可疑脓毒症的新生儿、儿童和成人患者血培养总阳性率分别为17.0%、13.3%和10.6%，随着时间的推移，这一比例呈下降趋势。在已鉴定的微生物中，成人患者中的革兰氏(+)和(-)细菌的比例相似(47.2%对44.5%)，而新生儿(77.4%)和儿童(73.2%)患者中的革兰氏(+)细菌占主导地位，并随着时间的推移而增加。血培养阳性率和微生物比例在大陆中国的不同地理区域有所不同。合并真菌的脓毒症很少见，但成人败血症患者(6.4%)比新生儿患者(0.8%)更常见。结论：城市和农村地区脓毒症死亡率的差异随着时间的推移而减小。男性、老年人和新生儿是高危人群。新生儿败血症以革兰氏(+)菌为主，成人败血症患者中革兰氏(+)或革兰氏(-)菌比例相似。(C)2014年提交人。爱思唯尔有限公司代表国际传染病学会出版。
Objectives: This study describes the epidemiological and microbiological profile of sepsis during the first decade of the 21st century in mainland China.Methods: The sepsis-related mortality data from 2003 and 2007 were retrieved from the China Health Statistical Yearbook. The microbiology data were retrieved and selected from a literature search of the China Academic Journal Database between 2001 and 2009. A meta-analysis was performed to synthesize the available data on the proportion of positive blood cultures in septic patients and the microorganism distribution.Results: The sepsis mortality in small and medium-sized cities and rural areas declined obviously over time. The mortality of the subpopulations aged 1-54 years tended to be lower than the national averages. In contrast, the sepsis mortality among neonates and the elderly (>= 75 years) was obviously higher than national averages. While the mortality in the elderly declined between 2003 and 2007, the neonate sepsis mortality increased dramatically, especially among male neonates. The overall positivity of blood culture were 17.0%, 13.3% and 10.6% among neonatal, pediatric and adult patients with suspected sepsis, respectively; this proportion tended to decrease over time. Among identified microorganisms, the proportions of Gram (+) and (-) bacteria were similar (47.2% vs. 44.5%) among adult patients, while Gram (+) bacteria was predominant among neonatal (77.4%) and pediatric (73.2%) patients and increased in prevalence over time. The positivity of blood cultures and proportions of microorganisms varied by geographical region across mainland China. Sepsis with fungus was rare but was more prevalent in adult sepsis patients (6.4%) than in neonatal patients (0.8%).Conclusions: The difference in sepsis mortality between urban and rural areas decreased over time. Males, the elderly, and neonates were found to be high-risk subpopulations. Gram (+) bacteria were predominant among neonates with sepsis, but the proportion of patients with Gram (+) or Gram (-) bacteria was similar among adults with sepsis. (C) 2014 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.