儿童铜绿假单胞菌脓毒症临床特点及预后分析

Clinical manifestations and prognosis of sepsis due to Pseudomonas aeruginosa in children

目的探讨儿童铜绿假单胞菌脓毒症临床特点、高危因素及预后。方法回顾性分析16例铜绿假单胞菌脓毒症患儿的临床资料。结果儿童铜绿假单胞菌脓毒症以婴幼儿多见;临床以发热、出血性皮疹、腹泻、肝脏肿大多见;白血病、手术创伤、婴幼儿为铜绿假单胞菌脓毒症高危因素。16例患儿中痊愈11例、好转出院3例、死亡2例。治愈及好转14例中11例初始治疗抗生素对铜绿假单胞菌敏感。结论儿童铜绿假单胞菌脓毒症表现多样,白血病患儿、手术创伤、婴幼儿疑诊脓毒症时应警惕铜绿假单胞菌,合适初始抗生素治疗有利于改善预后。

Objective To study the clinical manifestations, risk factors and the factors associated with poor prognosis in children with Pseudomonas aeruginosa sepsis. Methods The data of 16 children with Pseudomonas aeruginosa sepsis were analyzed retrospectively. Results Pseudomonas aeruginosa sepsis often occurred in infants and toddlers. Clinical manifestations of sepsis due to Pseudomonas aeruginos were varied including fever, bloody erythra, abdominal distension and diarrhea, and hepatomegaly. Most of children with Pseudomonas aeruginos sepsis had medical complication and leukemia was prominent. The risk factors for children with Pseudomonas aeruginosa sepsis were leukemia, surgical trauma, and young age. Among 16 children with sepsis due to Pseudomonas aeruginosa, 11 children were recovered, 3 children improved and discharged and 2 children died. Eleven children had sensitive initial antimicrobial therapy in 14 recovered or improved children. Conclusions Clinical manifestation in children with Pseudomonas aeruginosa sepsis is multiple. Once sepsis is suspected in children with leukemia or surgical trauma, or at young age, the pathogen of Pseudomonas aeruginos should be considered. Appropriate initial antimicrobial therapy can improve the outcome.