肺炎链球菌血流感染患儿的临床特点与生存状况研究

Clinical characteristics and living status of children with Streptococcus pneumoniae bloodstream infection

目的探索肺炎链球菌血流感染儿童的临床特点与生存状况。方法回顾性分析2015年2月-2018年2月医院接受治疗的116例肺炎链球菌血流感染患儿临床资料,应用最低抑菌浓度(MIC)测定法对患儿抗菌药物进行试验,对肺炎链球菌血流感染患儿死亡影响因素进行单因素和多因素分析。结果肺炎链球菌血流感染患儿年龄分布≤2岁占比、疾病分布肺炎患儿占比、季节分布冬季患儿占比最多。116株肺炎链球菌对克林霉素、红霉素、四环素抗菌药物耐药率较高,分别为98.28%、97.41%、88.79%。本次研究中患儿30天后共发生21例死亡,95例好转,好转组和死亡组有脑膜炎、有脓毒性休克数据对比具有统计学意义(P<0.05),有脑膜炎、有脓毒性休克是造成肺炎链球菌血流感染患儿死亡的独立危险因素(P<0.05)。结论肺炎链球菌血流感染多为≤2岁且并发肺炎患儿,冬季发病率较高,且肺炎链球菌对克林霉素、红霉素、四环素抗菌药物耐药率较高,有脑膜炎、有脓毒性休克患儿是死亡的独立危险因素。

OBJECTIVE To explore the clinical characteristics and living status of the children with Streptococcus pneumoniae bloodstream infection. METHODS The clinical data of 116 children with S.pneumoniae bloodstream infection who were treated in the hospital from Feb 2015 to Feb 2018 were retrospectively analyzed, the antibiotic testing was carried out by using minimum inhibitory concentration(MIC) method, and the univariate analysis and multivariate analysis were performed for the influencing factors for death of the children with S.pneumoniae bloodstream infection. RESULTS Among the children with S.pneumoniae bloodstream infection, the children who were aged no more than 2 years old and the children with pneumonia were dominant, and the bloodstream infection was prevalent in winter. The drug resistance rates of the 116 strains of S.pneumoniae to clindamycin, erythromycin and tetracycline were 98.28%, 97.41% and 88.79%, respectively. Totally 21 children died within 30 days, and 95 children were improved;there were significant differences in the incidence rates of meningitis and septic shock between the improvement group and the death group(P<0.05). The meningitis and septic shock were the independent risk factors for the death of the children with S.pneumoniae bloodstream infection(P<0.05). CONCLUSION The children who are aged no more than 2 years old and complicated with pneumonia are dominant among the children with S.pneumoniae bloodstream infection, the drug resistance rates of the S.pneumoniae strains to clindamycin, erythromycin and tetracycline are high. The meningitis and septic shock are the independent risk factors for the death of the children.