儿童侵袭性肺炎链球菌病54例临床特点及耐药性分析

临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (6): 555-558.

儿童侵袭性肺炎链球菌病54例临床特点及耐药性分析

张小龙¹, 罗征秀², 符州², 罗健², 刘恩梅²

1.成都市妇女儿童中心医院（四川成都　610091）；2.重庆医科大学附属儿童医院（重庆　400014）

收稿日期:2014-01-09 出版日期:2014-06-15 发布日期:2014-06-15

Clinical features and antibiotic resistance of 54 children with invasive pneumococcal disease

ZHANG Xiaolong¹, LUO Zhengxiu², FU Zhou², LUO Jian², LIU Enmei²

(1. Chengdu Women and Children Central Hospital, Chengdu 610091, Sichuan, China; 2. Children's Hospital of Chongqing Medical University, Chongqing 400014, China)

Received:2014-01-09 Published:2014-06-15 Online:2014-06-15

摘要/Abstract

摘要：

　目的　了解儿童侵袭性肺炎链球菌疾病（IPD）的临床特点及侵袭性肺炎链球菌（Sp）的耐药情况。方法　回顾性分析2009年至2012年收治的54例IPD患儿临床资料以及54株侵袭性Sp的药敏结果。结果　54例IPD患儿中男女比为1.35∶1，以<2岁的婴幼儿居多，夏季起病少；临床诊断以脓毒血症为主，其次为脑膜炎；患儿均有发热，且以中高热为主；44例出现白细胞计数增高，42例出现CRP增高；β-内酰胺类抗生素使用最多，其次为万古霉素。侵袭性Sp对青霉素的不敏感率达59.26%，多重耐药率高达96.30%。结论　IPD发病存在一定季节差异；临床表现多样，脓毒血症最常见；侵袭性Sp对青霉素耐药性较高。

Abstract: 　Objective　To investigate the clinical features of invasive pneumococcal disease (IPD) and the antimicrobial susceptibility of invasive Streptococcus pneumoniae (Sp). Methods The clinical features of 54 children with IPD and the antimicrobial susceptibility of 54 invasive Sp isolates were retrospectively analyzed from 2009 to 2012. Results The ratio of boys to girls in IPD was 1.35:1. Most of the children with IPD were within 2 years old. Few of the children had the onset in summer. Most of the children were diagnosed with septicemia, followed by meningitis. All of the children had middle or high fever. Forty-four children had an increased white blood cell count and 42 children had an increased C-reactive protein. β-lactam antibiotics was most frequently used in clinics, followed by vancomycin. Most of invasive Sp were resistant to penicillin. Multiple drug resistance was common in invasive Sp. Conclusions The incidence of IPD has seasonal difference. The clinical manifestations of IPD are diverse, with septicemia being the most common. The resistant rate to penicillin is high in invasive Sp.

张小龙, 罗征秀, 符州, 罗健, 刘恩梅. 儿童侵袭性肺炎链球菌病54例临床特点及耐药性分析[J]. 临床儿科杂志, 2014, 32(6): 555-558.

ZHANG Xiaolong,LUO Zhengxiu,FU Zhou,LUO Jian,LIU Enmei. Clinical features and antibiotic resistance of 54 children with invasive pneumococcal disease [J]. , 2014, 32(6): 555-558.

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