논문투고-심사위원수정

대한임상미생물학회

   접수번호

  20150024

   접수일

  2015-08-31

   구분

  원저

   교신저자

  이남용        (pioneer : 김영빈)

   소속

  성균관대학교 의과대학 삼성서울병원 진단검사의학교실

   이메일

  micro.lee@samsung.com

   제목

  11년간 단일 의료기관에서 발생한 Clostridium 균혈증 사례들에 대한 분석

   Running Title

  

   영문초록

  Background
Clostridial bacteremia is the second most frequent anaerobic bacteremia and CB patients show high mortality without prompt antimicrobial therapy. We retrospectively reviewed 11 years of CB cases in a tertiary care hospital to describe the clinical and microbiological characteristics of CB and to define the risk factors of fatal CB cases.
Methods
All patients with CB from January 2002 to December 2012 were included in the study. Age, sex, underlying diseases, antibiotic use, and clinical outcome were reviewed. Antibiotic therapy was classified as either “appropriate” or “insufficient” based on the activity against Clostridium species.
Results
A total of 118 Clostridium isolates (0.79% of all blood culture isolates) were recovered from the blood cultures of 114 patients. The underlying conditions of patients with CB were neoplasms in 87 cases (76.3%), gastrointestinal symptoms in 84 cases (73.7%), diabetes in 17 cases (14.9%), and hemodialysis in six cases (5.3%). Of the 118 Clostridium isolates, C. perfringens was the most frequent species (42 isolates, 35.6%). Thirty-two patients (28.1%) showed polymicrobial bacteremia, which was most commonly combined with Escherichia coli. Two patients had more than two Clostridium species. "Appropriate" antibiotics were given to 97 (85.1%) patients. The mortality rate of CB at days 2, 8, and 30 were 7.9% (9/114), 14.0% (16/114), and 26.3% (30/114), respectively.
Conclusion
Neoplasms especially from the gastrointestinal tract or of hematologic origin and hemodialysis were considered to be risk factors of blood stream clostridial infection. Malignancy also seemed to be associated with rapid mortality in patients with CB.

   Key Words

  Clostridium, Anaerobic bacteremia, Sepsis, Blood stream infection

   논문파일

1 . 표지(Title Page) A-20150024-1-00.docx 24 Kbytes 2015-08-31
2 . 본문(Main Body) A-20150024-2-00.docx 116 Kbytes 2015-08-31
3 . 이미지(Image File) A-20150024-3-00.pptx 3010 Kbytes 2015-08-31
4 . 국문초록 A-20150024-4-00.docx 27 Kbytes 2015-08-31
5 . 표지(Title Page) 1차 수정 A-20150024-1-01.docx 25 Kbytes 2015-10-07
6 . 본문(Main Body) 1차 수정 A-20150024-2-01.docx 128 Kbytes 2015-10-07
7 . 이미지(Image File) 1차 수정 A-20150024-3-01.pptx 3010 Kbytes 2015-10-07
8 . 국문초록 1차 수정 A-20150024-4-01.docx 27 Kbytes 2015-10-07
9 . 표지(Title Page) 2차 수정 A-20150024-1-02.docx 25 Kbytes 2015-10-15
10 . 본문(Main Body) 2차 수정 A-20150024-2-02.docx 127 Kbytes 2015-10-15
11 . 이미지(Image File) 2차 수정 A-20150024-3-02.pptx 3010 Kbytes 2015-10-15
12 . 국문초록 2차 수정 A-20150024-4-02.docx 27 Kbytes 2015-10-15
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