Đặc điểm một số chỉ số lâm sàng, cận lâm sàng ở bệnh nhân nhiễm khuẩn huyết thứ phát sau tắc mật

Abstract

Objective: To characterize manifestation of clinical and subclinical in patients with bacteria of secondary sepsis from cholestasis. Subject and method: We conducted a prospective study of 38 patients with secondary sepsis from cholestasis at the 108 Military Central Hospital from January 2020 to August 2020. Using BACTEC 9020 machine of Becton Dickinson - USA and identification of bacteria by Bio Merieux's Vitex II Compact system - France to determine the agent causing sepsis. Or PCR-based Sepsis@Quick test is for identifcation of sepsis-causative pathogens. Result: Men (63.2%) was higher than women (36.8%). The mean age was 64.8 ± 12.7 years. Fever and jaundice accounted for 100%, and abdominal pain accounted for 89.5%. 86.8% of patients had increased leukocytes. The mean bilirubin in plasma was 148.99 ± 114.83µmol/L. The mean of procalcitonin in plasma was 22.18 ± 27.16ng/ml. Sepsis-causative pathogens: Escherichia coli (55.3%), Klebsiella pneumoniae (31.6%). Patients using antibiotics aminoglycoside group (86.8%) and beta lactam group (84.2%) accounted for the highest percentage. Secondary sepsis from cholestasis: Biliary tract cancer (28.9%), gallstone (28.9%); hepatocellular carcinoma (13.2%). Conclusion: Etiology of secondary sepsis from cholestasis the most were Escherichia coli, the second is Klebsiella pneumoniae. The most common causes of biliary obstruction were biliary tract cancer, gallstones, and hepatocellular carcinoma.