细菌性和非细菌性败血症的比较分析:一项回顾性研究
Ryan Lee1,2, Rawaa Al Rifaie1, Keshab Subedi3
1Emergency Medicine, Christiana Care Health System, Newark, USA.
Cureus
|January 28, 2025
概括
培养负性败血症很常见,与与培养阳性败血症相似的患者结果相关,包括死亡率. 临床医生不应该假设在没有确诊的细菌病症的患者中结果更好.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 败血症是急诊室和ICU中经常出现的严重疾病.
- 培养负性败血症占病例的30-60%,对治疗和结果的影响尚不清楚.
- 关于格拉姆阳性和格拉姆阴性感染之间的差异,存在相互矛盾的证据.
研究的目的:
- 为了比较培养阳性与培养负性败血症的特征和结果.
- 分析细菌Gram染色对败血症结果的影响.
主要方法:
- 对1375名ICU患者 (2016-2019) 的回顾性队列研究.
- 包括患有败血症或败血性休克的患者,不包括没有培养或患有非细菌感染的患者.
- 主要结局:疾病的严重程度. 二次结果:死亡率,住院和ICU停留时间.
主要成果:
- 68.5%的患者是培养负的 (943/1375).
- 培养阳性患者使用血管压缩剂 (aOR 1.98) 和使用类固醇 (aOR 1.68) 的可能性更高.
- 在培养阳性和培养阴性组之间,死亡率或停留时间没有显著差异.
结论:
- 在培养阴性和培养阳性败血症之间存在严重的疾病严重程度差异.
- 患者导向的结局,如死亡率和停留时间在不同组之间是相似的.
- 临床医生不应该被怀疑败血症病例中没有细菌病的缺席所安慰.
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