Incidence, site, and outcome of infections in patients with the adult respiratory distress syndrome.
Incidence, site, and outcome of infections in patients with the adult respiratory distress syndrome.
复制标题
成人呼吸窘迫综合征患者感染的发生率、部位和结果。
DOI：
10.1164/arrd.1986.134.1.12
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
JohansonJr,WG
中科院分区：
文献类型：
--
作者：
Seidenfeld,JJ;Pohl,DF;Bell,RC;Harris,GD;JohansonJr,WG
成人呼吸窘迫综合征(ARDS)中的细菌感染与多器官衰竭和死亡的发生有关。我们研究了129名ARDS患者的108例感染，并评估了负责的微生物、涉及的身体部位和治疗结果。革兰氏阴性杆菌占微生物病原菌的57%，革兰氏阳性球菌占36%。只有7%的感染是由其他微生物(真菌、病毒、肺孢子虫、军团菌)引起的。革兰氏阴性菌更常见于肺、腹部和胸膜。腹部感染的菌血症(11/17，67%)比其他部位的感染(18/65，28%)更常见(p>；0.01)；9名患者的菌血症来自临床未发现的部位。17例腹部感染患者中有10例存活(59%)，而56例肺部感染患者中存活7例(13%)(p>；0.001)。通过对细菌敏感性和抗生素使用情况的回顾，发现接受充分抗生素治疗的患者存活率(20/69，29%)并不高于抗生素治疗不足的患者(3/13，23%)。这些数据表明，需要对ARDS患者的感染进行进一步的调查，重点应该放在发病机制、预防和宿主反应上。
Bacterial infection in the adult respiratory distress syndrome (ARDS) is associated with the occurrence of multiple organ failures and death. We studied 108 infections in 129 patients with ARDS and evaluated the organisms responsible, the body sites involved, and the outcomes of therapy. Gram-negative bacilli represented 57% of the microbial pathogens and gram-positive cocci 36%. Only 7% of infections were caused by other organisms (fungi, viruses,Pneumocystis, Legionella).Gram-negative organisms were more common in the lung, abdomen, and pleura. Bacteremia was more common in abdominal infections (11 of 17, 67%) than in infections at other sites (18 of 65, 28%), (p > 0.01); ;9 patients were bacteremic from clinically undetected sites. Ten of 17 (59%) patients with abdominal infections survived compared with 7 of 56 (13%) patients with lung infections (p > 0.001). A retrospective review ofin vitroorganism susceptibility and the antibiotics administered revealed that the patients who received adequate antibiotic therapy did not have a higher survival rate (20 of 69, 29%) than those who received inadequate antibiotic therapy (3 of 13, 23%). These data suggest that further investigation of infections in patients with ARDS is required and that emphasis should be placed on pathogenesis, prevention, and host responses.