tailieunhanh - Báo cáo y học: " Gram-negative bacteremia induces greater magnitude of inflammatory response than Gram-positive bacteremia"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Gram-negative bacteremia induces greater magnitude of inflammatory response than Gram-positive bacteremia. | Abe et al. Critical Care 2010 14 R27 http content 14 2 R27 c CRITICAL CARE RESEARCH Open Access Gram-negative bacteremia induces greater magnitude of inflammatory response than Gram-positive bacteremia Ryuzo Abe Shigeto Oda Tomohito Sadahiro Masataka Nakamura Yo Hirayama Yoshihisa Tateishi Koichiro Shinozaki Hiroyuki Hirasawa Abstract Introduction Bacteremia is recognized as a critical condition that influences the outcome of sepsis. Although large-scale surveillance studies of bacterial species causing bacteremia have been published the pathophysiological differences in bacteremias with different causative bacterial species remain unclear. The objective of the present study is to investigate the differences in pathophysiology and the clinical course of bacteremia caused by different bacterial species. Methods We reviewed the medical records of all consecutive patients admitted to the general intensive care unit ICU of a university teaching hospital during the eight-year period since introduction of a rapid assay for interleukin IL -6 blood level to routine ICU practice in May 2000. White blood cell count C-reactive protein CRP IL-6 blood level and clinical course were compared among different pathogenic bacterial species. Results The 259 eligible patients as well as 515 eligible culture-positive blood samples collected from them were included in this study. CRP IL-6 blood level and mortality were significantly higher in the septic shock group n 57 than in the sepsis group n 127 P . The 515 eligible culture-positive blood samples harbored a total of 593 isolates of microorganisms Gram-positive 407 Gram-negative 176 fungi 10 . The incidence of Gramnegative bacteremia was significantly higher in the septic shock group than in the sepsis group P and in the severe sepsis group n 75 P . CRP and IL-6 blood level were significantly higher in Gram-negative bacteremia n 176 than in Gram-positive bacteremia n 407 P respectively . .