균혈증을 동반한 지역사회획득 중증패혈증환자의 예후인자: 전향 적, 관찰연구 (Prognostic Factors of Community-acquired Bacteremic Patients with Severe sepsis: A Prospective, Observational Study)

서지정보

· 발행기관 : 대한감염학회
· 수록지 정보 : Infection and Chemotherapy / 44권 / 3호 / 168 ~ 174페이지
· 저자명 : 윤영경, 김민자, 박대원, 권순선, 천병철, 정희진, 최준용, 최희정, 최영화, 김효열, 엄중식, 김상일, 송영구, 백경란, 김양수, 김준명, 손장욱

초록

Background: Characterization of clinical features of bacteremic severe sepsis acquired from the community has been inadequate; therefore, our goal in this study was to identify prognostic factors associated with outcome in patients with community-acquired bacteremic severe sepsis.
Materials and Methods: Adult patients (≥18 years) with community-acquired severe sepsis in whom pathogens were identified from blood cultures were included in the study. Data were collected prospectively from 12 teaching hospitals between May,2005, and February, 2009. Data included demographic characteristics, co-morbid medical conditions, primary infection sites, sepsis severity, mortality, causative microorganisms,and the appropriateness of initial empirical antibiotic therapy.
Results: During the study period, 1,152 patients were diagnosed with communityacquired severe sepsis and 422 patients were found to harbor pathogens in their blood. Among the 422 patients analyzed, 253 (60.0%) patients went into shock and 121 patients (28.7%) died during hospitalization. Risk factors, including respiratory tract infection (odds ratio [OR], 2.60; 95% confidence interval [CI], 1.11-6.09), number of organ dysfunctions (OR, 1.39; 95% CI, 1.13-1.71), and higher APACHE II scores (OR, 1.08; 95% CI, 1.03-1.13) showed an association with poor survival, whereas Escherichia coli as a pathogen (OR, 0.31; 95% CI, 0.16-0.64) showed an association with lower mortality.
Conclusions: In addition to severity of illness, the primary site of infection and causative microorganisms were also identified as important prognostic factors in patients with community-acquired bacteremic severe sepsis.

영어초록

Background: Characterization of clinical features of bacteremic severe sepsis acquired from the community has been inadequate; therefore, our goal in this study was to identify prognostic factors associated with outcome in patients with community-acquired bacteremic severe sepsis.
Materials and Methods: Adult patients (≥18 years) with community-acquired severe sepsis in whom pathogens were identified from blood cultures were included in the study. Data were collected prospectively from 12 teaching hospitals between May,2005, and February, 2009. Data included demographic characteristics, co-morbid medical conditions, primary infection sites, sepsis severity, mortality, causative microorganisms,and the appropriateness of initial empirical antibiotic therapy.
Results: During the study period, 1,152 patients were diagnosed with communityacquired severe sepsis and 422 patients were found to harbor pathogens in their blood. Among the 422 patients analyzed, 253 (60.0%) patients went into shock and 121 patients (28.7%) died during hospitalization. Risk factors, including respiratory tract infection (odds ratio [OR], 2.60; 95% confidence interval [CI], 1.11-6.09), number of organ dysfunctions (OR, 1.39; 95% CI, 1.13-1.71), and higher APACHE II scores (OR, 1.08; 95% CI, 1.03-1.13) showed an association with poor survival, whereas Escherichia coli as a pathogen (OR, 0.31; 95% CI, 0.16-0.64) showed an association with lower mortality.
Conclusions: In addition to severity of illness, the primary site of infection and causative microorganisms were also identified as important prognostic factors in patients with community-acquired bacteremic severe sepsis.

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