摘要
目的分析侵袭性肺炎链球菌感染患儿的临床特点及对常用抗菌药物的耐药性,观察患者炎症因子水平的变化。方法选择医院2008年1月-2017年12月收治的侵袭性肺炎链球菌病患儿200例为研究组,并选择健康体检儿童200例作为对照组。收集侵袭性肺炎链球菌感染患儿临床资料,采用纸片扩散法联合E-test分析肺炎链球菌对常用抗菌药物的敏感性。观察患儿血清炎症因子水平变化情况。结果 200例侵袭性肺炎链球菌病患儿,年龄以5岁以内多见占89.5%,其中<2岁患儿为128例占64.00%;以社区获得性感染为主占87.50%,冬春季发病为主占74.50%,有基础疾病占25.00%,诊断为败血症占42.50%;患儿临床症状均表现为发热,肝脾肿大占32.00%,皮疹占11.50%;实验室检查白细胞升高占79.00%,治疗后,治愈患儿占72.00%,好转占23.00%,死亡占5.00%;侵袭性肺炎链球菌对红霉素、阿奇霉素、四环素、克林霉素、磺胺甲噁唑/甲氧苄啶耐药率较高,未出现万古霉素、利福平、利奈唑胺耐药菌株。血清高敏C-反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)、白介素-4(IL-4)、白介素-6(IL-6)、降钙素原(PCT)水平均高于对照组(P<0.05)。结论侵袭性肺炎链球菌病患儿以5岁以下多见,有季节性,临床表现多种多样,败血症最常见,耐药问题严峻,血清hs-CRP、TNF-α、IL-4、IL-6、PCT水平升高。
OBJECTIVE To investigate the clinical characteristics of children with invasive Streptococcus pneumoniae infection and drug resistance to commonly used antibiotics and observe the change of levels of inflammatory factors.METHODS A total of 200 children with invasive S.pneumoniae infection who were treated in the hospital form Jan 2008 to Dec 2017 were chosen as the study group,and 200 healthy children who received physical examination were set as the control group.The clinical data were collected from the children with invasive S.pneumoniae infection,the drug susceptibility testing for the commonly used antibiotics was performed by using disk diffusion method combined with E-test.The levels of serum inflammatory factors were observed.RESULTS Of the 200 children with invasive S.pneumoniae infection,the children aged no more than 5 years old accounted for 89.5%,the children aged less than 2 years old accounted for 64.00%(128 cases);87.50%had community-acquired infection,74.50%had the infection in winter and spring,25.00%had underlying diseases,and 42.50%were diagnosed with septicemia.Among the clinical symptoms,all of the children had fever,32.00%had hepatosplenomegaly,and11.50%had rash.The result of laboratory test showed that 79.00%had the elevated level of white blood cell,72.00%were cured after the treatment,23.00%were improved,and 5.00%died.The drug resistance rates of the invasive S.pneumoniae strains to erythromycin,azithromycin,tetracycline,clindamycin and sulfamethoxazole-trimethoprimazole were relatively high,and no strains resistant to vancomycin,rifampicin or linezolid were detected.The levels of serum high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor(TNF-α),interleukin-4(IL-4),interleukin-6(IL-6)and procalcitonin(PCT)were significantly higher in the study group than in the control group(P<0.05).CONCLUSION The invasive S.pneumoniae infection is prevalence among the children aged less than 5 years old and shows seasonal change;septicemia is the most common clinical manifestation,the stra
作者
俞慧君
孙颖
单建聪
杭金国
管敏昌
YU Hui-jun;SUN Ying;SHAN Jian-cong;HANG Jin-guo;GUAN Min-chang(Taizhou Enze Medical Center(Group)Luqiao Hospital,Taizhou,Zhejiang318050,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第9期1416-1420,共5页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生一般研究计划基金资助项目(2015KYB446)
关键词
患儿
侵袭性肺炎链球菌病
耐药
高敏C-反应蛋白
肿瘤坏死因子-Α
Child
Invasive Streptococcus pneumoniae
Drug resistance
High-sensitivity C-reactive protein
Tumor necrosis factor-α
