Clinical manifestations, risk factors and prognosis of patients with Morganella morganii sepsis

被引:41
作者
Erlanger, David [1 ,2 ]
Assous, Marc Victor [3 ]
Wiener-Well, Yonit [1 ]
Yinnon, Amos Moshe [4 ]
Ben-Chetrit, Eli [1 ]
机构
[1] Hebrew Univ Jerusalem Hadassah Hosp & Med Sch, Med Sch, Fac Med, Shaare Zedek Med Ctr,Infect Dis Unit, Jerusalem, Israel
[2] Technion Israel Inst Technol, Ruth & Bruce Rappaport Fac Med, Haifa, Israel
[3] Hebrew Univ Jerusalem Hadassah Hosp & Med Sch, Med Sch, Shaare Zedek Med Ctr, Fac Med,Clin Microbiol & Immunol Lab, Jerusalem, Israel
[4] Hebrew Univ Jerusalem Hadassah Hosp & Med Sch, Med Sch, Fac Med, Shaare Zedek Med Ctr,Div Internal Med, Jerusalem, Israel
关键词
Morganella morganii bacteremia; Sepsis; Polymicrobial bacteremia; Soft tissue infection; ENDOPHTHALMITIS; CLASSIFICATION; EPIDEMIOLOGY; ARTHRITIS; PROTEUS;
D O I
10.1016/j.jmii.2017.08.010
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: There are few studies of Morganella bacteremia. We evaluated risk factors and outcome of patients with Morganella bacteremia. Methods: Medical records of patients with Morganella bacteremia were reviewed (1997-2014). Control group patients with Escherichia coli sepsis were matched by year of diagnosis and infection acquisition site. Results: The study group included 136 adult patients. Mean age and gender of study and control groups were similar. Complicated soft tissue infection was more prevalent in the study group (30% versus 3.2%, p < 0.05). The Charlson Comorbidity Index (CCI) was higher in the study group (4.3 +/- 2.5 versus 3.4 +/- 2.8, p < 0.05). Only 78 (62%) of the study patients versus 101 (83%) of the control group (p < 0.05), received appropriate empirical antibiotic treatment. A significantly higher in-hospital mortality rate (42% versus 25%, p < 0.05) as well as longer length of stay (25 +/- 22 versus 14 +/- 16 days, p < 0.05) was observed in the study group. Multivariate analysis revealed that a debilitative state, a CCI > 4, septic shock and a clinical syndrome other than UTI were all significant risk factors for mortality (p < 0.05). Conclusions: Patients with Morganella morganii sepsis had more co-morbidities and a worse degree of sepsis. There is an increased risk of inappropriate empirical treatment, longer hospitalization and higher death rate. Copyright (C) 2017, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC.
引用
收藏
页码:443 / 448
页数:6
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