Clinical analysis of community-acquired Pseudomonas aeruginosa septic shock

OBJECTIVE: This study sought to analyze the clinical manifestations and intervention of fulminant septic shock in community-acquired Pseudomonas aeruginosa septicemia

Bibliographische Detailangaben
Veröffentlicht in:Zhonghua er ke za zhi = Chinese journal of pediatrics. - 1960. - 46(2008), 5 vom: 22. Mai, Seite 333-9
1. Verfasser: He, Shi-jun (VerfasserIn)
Weitere Verfasser: Jin, Yi-mei, Huang, Ai-rong, Wang, Chuan-xia, Zhou, Ai-hua, Wang, Xia, Shan, Xiao-ou
Format: Aufsatz
Sprache:Chinese
Veröffentlicht: 2008
Zugriff auf das übergeordnete Werk:Zhonghua er ke za zhi = Chinese journal of pediatrics
Schlagworte:Journal Article
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245 1 0 |a Clinical analysis of community-acquired Pseudomonas aeruginosa septic shock 
264 1 |c 2008 
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500 |a Citation Status MEDLINE 
520 |a OBJECTIVE: This study sought to analyze the clinical manifestations and intervention of fulminant septic shock in community-acquired Pseudomonas aeruginosa septicemia 
520 |a METHODS: We retrospectively reviewed the medical records for diagnosis, antibiotic therapy, clinical course of septic shock, respiratory support, laboratory data etc 
520 |a RESULTS: Eight of nine cases with P. aeruginosa septic shock died. Fever (nine cases) and cough (three cases) or diarrhea (3 cases) were the 2 most common initial symptoms, three cases developed skin gangrenosum later. Pseudomonas aeruginosa infection was not considered in any of the cases before death or blood culture showed positive result. Only 3 cases were initially treated with susceptible antibiotic regimen but no anti pseudomonas combination therapy was applied, susceptible antibiotic monotherapy was applied in 7 cases after transfer to the ICU. The mean latency of shock occurrence was 5.1 hours (range 0 to 21 hours) after admission, the mean duration from the occurrence of shock to death was 13.8 hours (range, 1 - 32 hours). All the patients were transfer red to ICU for shock, the appropriate resuscitation of shock patients was delayed by 49.3 minutes (range 25 - 80 minutes) by transfer. Only two cases were diagnosed and treated for shock on admission; after transferred to ICU, only 5 patients were diagnosed as having shock, and only 3 received anti-shock treatment. Eight of the patients died of persistent shock. In 6 patients who died, mechanical ventilation was not applied until cardiac arrest occurred. All the patients had hypoalbuminaemia, elevated serum C-reactive protein concentration, leukopenia and 6 cases had DIC 
520 |a CONCLUSION: The initial presentation of the cases with community-acquired Pseudomonas aeruginosa septicemia was nonspecific with fever and cough or diarrhea. Clinicians often underestimated the severity of the infection, few patients received effective antimicrobial therapy. The authors suggest that an anti-pseudomonas antibiotic should be included in the initial empiric antibiotic regimen to cover P. aeruginosa high-risk patients; the front-line clinician should be educated for early recognition and aggressive resuscitation of P infection. aeruginosa septicemia 
650 4 |a Journal Article 
700 1 |a Jin, Yi-mei  |e verfasserin  |4 aut 
700 1 |a Huang, Ai-rong  |e verfasserin  |4 aut 
700 1 |a Wang, Chuan-xia  |e verfasserin  |4 aut 
700 1 |a Zhou, Ai-hua  |e verfasserin  |4 aut 
700 1 |a Wang, Xia  |e verfasserin  |4 aut 
700 1 |a Shan, Xiao-ou  |e verfasserin  |4 aut 
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