Massive intravascular hemolysis is an important factor in Clostridium perfringens-induced bacteremia
Massive intravascular hemolysis is an important factor in Clostridium perfringens-induced bacteremia
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大量血管内溶血是产气荚膜梭菌菌血症的重要因素
DOI：
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发表时间：
2022
影响因子：
4.6
通讯作者：
S. Hayakawa
中科院分区：
文献类型：
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作者：
A. Suzaki;Shihoko Komine;H. Nishiyama;S. Hayakawa
产气荚膜梭菌菌血症是罕见的，但往往是致命的。特别是一旦发生菌血症伴大量血管内溶血（MIH），死亡率极高。然而，由于其罕见性，这种暴发性菌血症的详细病理生理学尚不清楚。为了阐明MIH的详细发病机制，我们回顾性分析了所有C。2000年至2014年两所大学医院的产气荚膜杆菌菌血症。对60例菌血症患者的病历及实验室检查资料进行分析，其中6例合并MIH，54例未合并MIH。与非MIH患者相比，MIH患者发作时剧烈疼痛、意识障碍、休克、血尿、代谢性酸中毒和气体形成的发生率更高。两组临床分离株的抗生素敏感性差异无统计学意义。所有MIH患者，尽管接受了适当的抗菌药物治疗，但均在入院后26小时内死于快速进行性急性肺损伤或急性呼吸窘迫综合征，从到达医院到死亡的中位时间仅为4小时20分钟。当临床医生观察到具有MIH特征性症状的患者血液样本中存在血管内溶血时，他们应该为严重的疾病后果做好准备。暴发性病例的潜在病理生理学必须进行调查。
Clostridium perfringens bacteremia is rare but often fatal. In particular, once bacteremia with massive intravascular hemolysis (MIH) occurs, the mortality rate is extremely high. However, because of its rarity, the detailed pathophysiology of this fulminant form of bacteremia is unclear. To elucidate the detailed pathogenesis of MIH, we retrospectively reviewed the data of all patients with C. perfringens bacteremia from two university hospitals from 2000 to 2014. The medical records and laboratory data of 60 patients with bacteremia, including 6 patients with MIH and 54 patients without MIH, were analyzed. Patients with MIH had higher rates of intense pain at onset, impaired consciousness, shock at presentation, hematuria, metabolic acidosis, and gas formation than patients without MIH. The antibiotic susceptibility of the clinical isolates was not significantly different between the two groups. All patients with MIH, although treated with appropriate antimicrobial agents, died within 26 h of admission due to rapidly progressive acute lung injury or acute respiratory distress syndrome, and the median time from arrival at the hospital to death was only 4 h and 20 min. When clinicians observe intravascular hemolysis in blood samples from patients with characteristic symptoms of MIH, they should prepare for a severe disease outcome. The underlying pathophysiology of fulminant cases must be investigated.
影响因子：
4.2
作者：
Verherstraeten S;Goossens E;Valgaeren B;Pardon B;Timbermont L;Haesebrouck F;Ducatelle R;Deprez P;Wade KR;Tweten R;Van Immerseel F
通讯作者：
Van Immerseel F
影响因子：
3.1
作者：
Uzal FA;Freedman JC;Shrestha A;Theoret JR;Garcia J;Awad MM;Adams V;Moore RJ;Rood JI;McClane BA
通讯作者：
McClane BA