前言对败血症患者的抗菌治疗,往往是在得到血培养结果之前就必须开始。因此,临床医师应时刻了解在他们的科室内造成菌血症的致病微生物变换情况,在不同的时期致病菌也不同。在抗生素出现之前的时代,至少有一半的菌血症是由肺炎双球菌属和链霉菌属引起的。从战后到六十年代,金黄色葡萄球菌感染所致的菌血症则普遍流行,而在随后的那些年来,革蓝氏阴性菌的数量却有显著地增加。在汉堡大学医院,分离出革蓝氏阴性菌的百分率,1964年为25%,而1967年则增加到60%。从70年代中期以来,革蓝氏阳性菌又占了明显的优势。凝血酶阴性葡萄 Introduction Antibacterial treatment of sepsis patients often begins before blood culture results are obtained. Therefore, clinicians should keep abreast of pathogenic microbial transformations that cause bacteremia in their department, with different pathogens at different times. In the pre-antibiotic era, at least half of the bacteremia was caused by pneumococci and Streptomyces. Bacteraemia caused by Staphylococcus aureus was prevalent from the second half of the war to the 1960s, while the number of gram negative bacteria increased significantly in the subsequent years. At Hamburg University Hospital, the percentage of gram-negative bacteria isolated was 25% in 1964 and 60% in 1967. Since the mid-1970s, Gram-positive bacteria account for significant advantages. Thrombin-negative grape