Analysis of 1,186 episodes of gram-negative bacteremia in non-university hospitals: the effects of antimicrobial therapy.
Analysis of 1,186 episodes of gram-negative bacteremia in non-university hospitals: the effects of antimicrobial therapy.
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非大学医院 1,186 例革兰氏阴性菌血症的分析：抗菌治疗的效果。
DOI：
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发表时间：
1983
期刊：
影响因子：
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通讯作者：
E. Brenner
中科院分区：
文献类型：
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作者：
C. Bryan;Kenneth L. Reynolds;E. Brenner
在1977-1981年的五年期间，我们研究了由肠杆菌科和假单胞菌科引起的1186例菌血症。总体患者死亡率为36.3%，感染导致的死亡率为19.0%。基础疾病的严重程度、感染部位、微生物和年龄的重要性得到了证实，这些因素以前在三级护理中心进行的研究中被确定为预后因素。与使用无效的抗菌剂或根本不进行治疗相比，适当的初始抗菌治疗(定义为在血培养阳性的第一个日历日以适当的剂量和适当的给药途径给予有效的药物)并不能提高存活率。然而，在血培养阳性的第一个日历日之后进行适当的抗菌治疗显然会影响存活率。这些发现证实了先前关于革兰氏阴性菌血症的频率和严重程度以及抗菌治疗对这种情况的总体影响的结论。这些研究还表明，应该重新考虑某些患者群体中最佳初始治疗的定义。
Over the five-year period 1977-1981, we studied 1,186 episodes of bacteremia due to Enterobacteriaceae and Pseudomonadaceae in the four non-university hospitals of a single metropolitan area. Overall patient mortality was 36.3%, and mortality attributed specifically to infection was 19.0%. The importance of severity of underlying disease, site of infection, microorganism, and age--previously determined to be prognostic factors in studies conducted at tertiary-care centers--was confirmed. Appropriate initial antimicrobial therapy (defined as the administration of an effective agent in adequate dose and by a suitable route of administration on the first calendar day on which blood cultures were positive) did not improve survival compared with the use of an ineffective antimicrobial agent or no therapy at all. However, appropriate antimicrobial therapy subsequent to the first calendar day on which blood cultures were positive clearly affected survival. These findings confirm previous conclusions regarding the frequency and severity of gram-negative bacteremia and the overall impact of antimicrobial therapy on this condition. These studies also suggest the possibility that the definition of optimal initial therapy in some groups of patients should be reconsidered.
用针对突变型大肠杆菌的人抗血清治疗革兰氏阴性菌血症和休克。
DOI：
10.1056/nejm198211113072001
发表时间：
1982
期刊：
The New England journal of medicine
影响因子：
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作者：
Ziegler,EJ;McCutchan,JA;Fierer,J;Glauser,MP;Sadoff,JC;Douglas,H;Braude,AI
通讯作者：
Braude,AI