Epidemiology of Nosocomial Infections Due to Gram-Negative Bacilli: Aspects Relevant to Development and Use of Vaccines
Epidemiology of Nosocomial Infections Due to Gram-Negative Bacilli: Aspects Relevant to Development and Use of Vaccines
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革兰氏阴性杆菌引起的医院感染的流行病学：与疫苗开发和使用相关的方面
DOI：
10.1093/infdis/136.supplement.s151
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发表时间：
1977
期刊：
影响因子：
--
通讯作者：
J. Bennett
中科院分区：
文献类型：
--
作者：
W. Stamm;S. M. Martin;J. Bennett
作为革兰氏阴性杆菌医院感染流行病学研究的一部分，我们对参与协作监测系统的 8 家医院向疾病控制中心报告的 5,457 例此类感染进行了分析，以确定 (1) 哪些感染最常导致菌血症或死亡，以及哪些患者； (2) 在住院期间或与选定的手术相关时，发生每种类型的感染； (3) 哪些患者发生每种特定革兰氏阴性菌感染的风险更大； (4) 感染率、菌血症或死亡率是否因感染微生物而异。报告了对四个感染部位（尿路、下呼吸道、手术伤口和血流）和六种革兰氏阴性病原体（大肠杆菌、变形杆菌、铜绿假单胞菌、肠杆菌、沙雷氏菌和克雷伯氏菌）的分析结果。就每个属引起特定感染、继发性菌血症或死亡的可能性而言，六种研究菌株之间仅存在微小差异。假单胞菌和沙雷氏菌作为长期住院患者的感染原因尤其重要。总之，对这六种常见院内病原体有效的免疫疗法（使用疫苗或超免疫血清）可能会对目前现有措施无法预防的医院获得性感染造成的发病率和死亡率产生重大影响。
As part of an epidemiological study of nosocomial infections due to gram-negative bacilli, 5,457 such infections reported to the Center for Disease Control from eight hospitals participating in a collaborative surveillance system were analyzed to determine (1) which infections most often resulted in bacteremia or fatality, and in which patients; (2) when, during hospitalization or in relation to selected procedures, each type of infection occurred; (3) which patients were at greater risk of developing each specific gram-negative infection; and (4) whether rates of infection, bacteremia, or fatality differed by infecting organism. The results of these analyses for four sites of infection (urinary tract, lower respiratory tract, surgical wounds, and bloodstream) and six gram-negative pathogens (Escherichia coli, Proteus, Pseudomonas aeruginosa, Enterobacter, Serratia, and Klebsiella) are presented. Only minor differences among the six study strains were noted with respect to the likelihood of each genus causing specific infections, secondary bacteremia, or death. Pseudomonas and Serratia were particularly important as causes of infection in patients who were hospitalized for a long time. In conclusion, immunotherapy (with a vaccine or hyperimmune serum) effective against these six common nosocomial pathogens would probably have a major impact on morbidity and fatality due to hospital-acquired infections that are not preventable by currently available measures.