普雷沃菌血流感染: 一项为期10年的单中心回顾性研究
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作者单位:

南京大学医学院附属鼓楼医院急诊科, 江苏 南京 210008

作者简介:

通讯作者:

范国峰  E-mail: fgfnjglyy@163.com

中图分类号:

R631

基金项目:

南京市卫生科技发展专项资金项目(YKK21091)


Prevotella bloodstream infection: a 10-year single-center retrospective study
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Affiliation:

Department of Emergency Medicine, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, China

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    摘要:

    目的 提高临床医生对普雷沃菌血流感染的认识,减少误诊和漏诊率,拓宽诊疗思路。 方法 收集2013年5月-2023年5月南京大学医学院附属某医院普雷沃菌血流感染患者的临床资料,回顾性分析普雷沃菌血流感染患者的危险因素、感染来源、感染菌种、临床表现、实验室检查结果、治疗及转归。 结果 共纳入23例确诊为普雷沃菌血流感染的患者,共中男性15例(65.2%),女性8例(34.8%)。大部分患者血流感染前有相关诱发因素,如手术操作(11例,47.8%)、恶性肿瘤(10例,43.5%)、糖尿病(9例,39.1%)、导尿管置入(10例,43.5%)等。感染菌种共9类,主要为颊普雷沃菌(6例,26.1%)、二路普雷沃菌(5例,21.7%)和中间普雷沃菌(4例,17.4%)。感染来源主要为肝胆系统(6例,26.1%)、腹腔及胸腔(4例,17.4%)和泌尿生殖道(4例,17.4%)。所有患者均有畏寒、发热表现,血液炎症指标明显升高,4例(17.4%)并发感染性休克,18例(78.3%)患者经恰当的抗感染治疗后预后良好。 结论 当怀疑不典型病原菌普雷沃菌血流感染时,应尽早去除诱发因素,积极留取血液送培养,依据药敏试验合理应用抗菌药物,有利于迅速控制感染,改善预后。

    Abstract:

    Objective To improve clinicians' understanding on Prevotella bloodstream infection (BSI), reduce the rate of misdiagnosis and missed diagnosis, and broaden the ideas of diagnosis and treatment. Methods Clinical data of patients with Prevotella BSI at a hospital affiliated to a medical school of Nanjing University from May 2013 to May 2023 were collected. Risk factors, sources of infection, strains of infection, clinical manifestations, laboratory test results, treatment, and outcomes of patients with Prevotella BSI were retrospectively analyzed. Results A total of 23 patients diagnosed with Prevotella BSI were included in analysis, 15 (65.2%) were males and 8 (34.8%) were females. Most patients had related predisposing factors before BSI, such as surgical procedures (n=11, 47.8%), malignant tumors (n=10, 43.5%), diabetes (n=9, 39.1%), and indwelling urinary catheter (n=10, 43.5%), etc. There were 9 types of infected bacteria, mainly Prevotella buccalis (n=6, 26.1%), Prevotella bivia (n=5, 21.7%) and Prevotella intermedia (n=4, 17.4%). The main sources of infection were hepatobiliary system (n=6, 26.1%), abdominal and thoracic cavities (n=4, 17.4%), as well as urogenital tract (n=4, 17.4%). All patients showed symptoms of chills and fever, with significantly elevated blood inflammation indicators. Four cases (17.4%) developed septic shock, and 18 cases (78.3%) had a good prognosis after appropriate anti-infection treatment. Conclusion When atypical BSI caused by Prevotella is suspected, predisposing factors should be removed as soon as possible, blood should be actively collected and performed culture, rational use of antimicrobial agents based on antimicrobial susceptibility testing is beneficial for rapid control of infection and improvement of prognosis.

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引用本文

周祎,王权鹏,范国峰.普雷沃菌血流感染: 一项为期10年的单中心回顾性研究[J]. 中国感染控制杂志,2024,23(3):305-309. DOI:10.12138/j. issn.1671-9638.20245160.
Yi ZHOU, Quan-peng WANG, Guo-feng FAN.Prevotella bloodstream infection: a 10-year single-center retrospective study[J]. Chin J Infect Control, 2024,23(3):305-309. DOI:10.12138/j. issn.1671-9638.20245160.

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  • 收稿日期:2023-10-27
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  • 在线发布日期: 2024-04-28
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