败血症是严重的全身性感染,平均病死率约30～40％,如在发生休克及脏器功能障碍前,未明确诊断和及时处理,则病死率可达64～88％。一、病原菌的变迁及分离经常注意败血症病原菌的动态变化对诊断及选择抗生素药物极为重要。有人统计,败血症的病原菌在本世纪40年代前,肺炎球菌和链球菌占半数以上,葡萄球菌约占1/5。由于青霉素等抗生素的广泛应用,前两种细菌引起的败血症已很少见,而耐青霉素的葡萄球菌明显增多,在50年代初达到高峰,占败血症的1/3。欧美等国在50年代后期至60年代初,革兰氏阴性杆菌(阴性杆菌)已成为败血 Sepsis is a serious systemic infection with an average mortality rate of about 30-40%. As before the diagnosis and timely treatment of shock and organ dysfunction, the case fatality rate can reach 64-88%. First, the pathogen changes and separation Often pay attention to the dynamic changes of sepsis pathogens diagnosis and selection of antibiotics is extremely important. Some statistics, pathogenic bacteria sepsis in the 40s of this century, pneumococcus and streptococcus accounted for more than half of Staphylococcus aureus accounted for about 1/5. Due to the extensive use of penicillin and other antibiotics, sepsis caused by the first two kinds of bacteria has been rare, while the penicillin-resistant staphylococci increased significantly, reaching a peak in the early 1950s, accounting for 1/3 of sepsis. Europe and the United States and other countries in the late 50s to early 60s, Gram-negative bacilli (negative bacilli) has become septicemia