摘要
目的 分析诺卡菌感染患者的临床特征、炎症指标和治疗转归情况,为早期识别和防治该病提供依据。方法 回顾性分析2018年至2023年39例诺卡菌感染患者临床资料,收集并分析患者炎症指标、病原学特点及治疗转归情况。结果 39例诺卡菌感染患者,36例合并有基础疾病;呼吸系统感染24例,皮肤感染11例,血流感染2例,尿路感染和淋巴管炎各1例;感染菌种分布为巴西诺卡菌11株,皮疽诺卡菌、圣乔治教堂诺卡菌和豚鼠耳炎诺卡菌各7株,亚洲诺卡菌2株,新咯里多尼亚诺卡菌1株,华莱士诺卡菌1株,未分型诺卡菌3株。炎症指标中C反应蛋白升高患者比例最多,占79.41%。临床治疗方案采用复方磺胺甲噁唑为基础的联合用药治疗,患者治愈率高。结论 诺卡菌可引起全身多部位感染,合并有基础疾病患者感染率更高。不同菌种引起的感染部位、临床表现和炎症指标不同,且不同菌种治疗效果相差较大,因此应根据诺卡菌感染患者的实验室检验结果选择有效治疗方案。
Objective To collect the clinical characteristics,inflammatory indicators and treatment of patients with Nocardia infections,and to provide a basis for early identification and prevention of the disease.Methods The clinical data of 39 patients with Nocardiosis from 2018 to 2023 were retrospectively analyzed,laboratory infection indexes,etiological characteristics and treatment were collected and analysed.Results Of the 39 patients with Nocardia infection,36 cases were combined with underlying diseases.There were 24 cases of respiratory system infection,11 cases of skin infection,2 cases of systemic disseminated infection,and 1 case each of urinary tract infections and lymphadenitis.The distribution of infectious organisms was Nocardia brasiliensis in 11 cases,Nocardia farcinica,Nocardia cyriacigeorgica,and Nocardia otitidiscaviarum in 7 cases,Nocardia beijingensis in 2 cases,Nocardia neocaledoniensis in 1 case,Nocardia wallacei in 1 case,and unclassified Nocardia in 3 cases.The proportion of patients with elevated laboratory inflammatory index C-reactive protein was the highest,accounting for 79.41%.The clinical treatment plan was based on the combination of compound sulfamethoxazole,and the cure rate of patients was high.Conclusion The Nocardiae can cause systemic multi-site infection,and the infection rate is higher in patients with underlying diseases.Different strains of Nocardia cause different sites of infection,clinical manifestations and inflammatory indicators,and the therapeutic effects of different strains are also quite different.Therefore,the appropriate treatment plan should be selected according to the laboratory test results.
出处
《浙江临床医学》
2024年第7期995-997,共3页
Zhejiang Clinical Medical Journal
基金
浙江省医药卫生科技计划项目(2023KY330)。
关键词
诺卡菌
感染
病原学
Nocardia
Infection
Pathogenesis
