Gram-Negative Bacteremia upon Hospital Admission: When Should Pseudomonas aeruginosa Be Suspected?
Gram-Negative Bacteremia upon Hospital Admission: When Should Pseudomonas aeruginosa Be Suspected?
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DOI：
10.1086/596709
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发表时间：
2009-03-01
影响因子：
11.8
通讯作者：
Carmeli, Yehuda
中科院分区：
文献类型：
--
作者：
Schechner, Vered;Nobre, Vandack;Carmeli, Yehuda
背景。铜绿假单胞菌是无严重免疫缺陷患者社区获得性菌血症的罕见原因。由于限制不必要使用抗假单胞菌药物的需要与避免延迟适当治疗的需要之间存在矛盾，因此临床医生需要更好的指导来确定何时根据经验覆盖铜绿假单胞菌。我们试图确定入院时铜绿假单胞菌菌血症的发生情况并构建预测模型。方法。对4家三级甲等医院进行了回顾性研究。检索微生物学数据库发现所有由革兰氏阴性杆菌（GNR）引起的菌血症发作均存在= 2个预测因子，风险增加至接近1：3。结论。在没有严重免疫缺陷的患者入院时出现铜绿假单胞菌菌血症的情况很少见。对于疑似 GNR 菌血症的免疫功能正常且预测因子≥2 的患者，需要进行经验性抗假单胞菌治疗。
Background. Pseudomonas aeruginosa is an uncommon cause of community-acquired bacteremia among patients without severe immunodeficiency. Because tension exists between the need to limit unnecessary use of anti-pseudomonal agents and the need to avoid a delay in appropriate therapy, clinicians require better guidance regarding when to cover empirically for P. aeruginosa. We sought to determine the occurrence of and construct a model to predict P. aeruginosa bacteremia upon hospital admission.Methods. A retrospective study was conducted in 4 tertiary care hospitals. Microbiology databases were searched to find all episodes of bacteremia caused by gram-negative rods (GNRs) = 2 predictors existed, the risk increased to nearly 1: 3.Conclusions. P. aeruginosa bacteremia upon hospital admission in patients without severe immunodeficiency is rare. Among immunocompetent patients with suspected GNR bacteremia who have >= 2 predictors, empirical anti-pseudomonal treatment is warranted.