儿童血培养分离到少动鞘氨醇单胞菌40例临床分析

Clinical features of children with positive blood culture for Sphingomonas paucimobilis

目的了解血培养少动鞘氨醇单胞菌阳性息儿的临床特点及其治疗。方法采用回顾性分析的方法,分析近5年中,血培养分离到的少动鞘氯醇单胞菌的体外耐药模式、患儿临床特点和治疗效果。结果研究年限中,血培养分离到少动鞘氨醇单胞菌的患儿共40例,男性占62.5%,年龄7d^12.5岁,平均(41.4±40.7)个月,<3岁占67.5%。季节分布显示,4~9月占77.5%。55%的息儿超敏C反应蛋白高于正常,所有患儿均有基础疾病,以下呼吸道感染、血液系统恶性肿瘤和经历外科手术最为常见,分别占40%、27.5%和15%。体外药敏结果显示菌株对亚安培南和美洛培南的敏感率高达94.6%和96.8%,对头孢哌酮舒巴坦的敏感率85.3%。临床治疗显示第三代头孢菌素也有良好的体内抗菌效果,所有患儿该菌感染均治愈。结论儿童少动鞘氨醇单胞菌感染预后较好,第三代头孢菌素和碳青霉烯类抗生素是治疗该菌感染的有效药物。

Objective To review the clinical features of children with positive blood culture for Sphingomonas paucimobilis （S. paucimobilis）. Methods The clinical and laboratory data of 40 children with positive S. paucimobilis culture, who were admit-ted from September 2006 to August 2011, were retrospectively analyzed. Results The mean age of patients was 41.4±40.7m （7d^12.5y） and 67.5%were〈3y, among whom 62.5%were boys. 77.5%of patients were diagnosed during April to September and 55%had high CRP levels. All patients had underlying conditions, low respiratory tract infection was leading one （40%）, fol-lowed by hematological disorders（27.5%） and surgical operation（15%）. Drug resistant test showed that 94.6%of the strains were sensitive to imipenem, 96.8%were sensitive to meropenem and 85.3%were sensitive to cefoperazon- sulbactam sodium. Thera-peutic outcome showed that the third generation cephalosporins were effective and al patients were cured. Conclusion Children with S. paucimobili infection have favorable prognosis, the third generation cephalosporin and carbopenems are effective for in-fection of S. paucimobilis.