粪便气单胞菌培养在小儿炎症性肠病严重程度和临床结局中的价值

The clinical value of Aeromonas culture in the severity and outcome of inflammatory bowel disease in children

[目的]探讨粪便阳性气单胞菌培养在小儿炎症性肠病患者中的重要性。[方法]收集2016年6月~2018年6月在我院就诊的37例胃肠病患儿,收集患儿粪便并进行气单菌的培养,通过基质辅助激光解析电离飞行时间质谱(MALDL-TOF-Ms)鉴定气单菌。比较分析气单胞菌的分布,患者的临床特征和严重感染的危险因素等。[结果]共鉴筛选出37例肠胃病患儿,其中11例为炎症性肠病(IBD)。37例患儿中,由气单菌感染引起的胃肠道疾病共32例,22例为气单胞菌引起轻度自限性胃肠道感染,10例为气单胞菌引起轻度至中度胃肠道感染,其中4例患儿轻度至中度胃肠道感染的患儿还伴有肠外并发症。11例IBD患儿中,共有8例为克罗恩病(CD)的患儿,3例为溃疡性结肠炎患儿。相比之下,1例患溃疡性结肠炎患儿和2例患有CD的患儿中气单胞菌仅引起轻微的胃肠道感染。在4例患有CD的患儿中,气单胞菌的活跃程度与致病作用并没有相关性。[结论]气单胞菌主要引起轻度感染,但也可引起中度和重度感染。气单胞菌在非炎性肠病的患儿中也可引起较轻微的感染。

[Objective]To explore the significance of positive Aeromonas cultures in children with inflammatory bowel disease.[Methods]Retrospective study including 37 patients with a culture positive for Aeromonas between June 2016 and June 2018. Collection stool from patients and appropriate incubation, all suspected colonies were identified by MALDI.TOFMS. Analyze the distribution of Aeromonas, the clinical characteristics of patients and risk factors for serious infections. [Results]A total of 37 patients(11 IBD) were identified. A total of 32 astrointestinal disease caused by Aeromonas infection in these 37 patients, 22 of which were mild self-limiting gastrointestinal infections and 10 were mild-to-moderate gastrointestinal infection caused by Aeromonas, 4 suffered from extraintestinal complications. Of the 11 children with inflammatory bowel disease, 8 had Crohn’s disease and 3 had ulcerative colon. In contrast, in 1 patient with ulcerative colitis and 2 patients with Crohn’s disease, Aeromonas caused a mild gastrointestinal infection not worsening the disease activity and in 4 patients with Crohn’s disease, it presented in the context of active disease with no clear pathogenic role.[Conclusion]Aeromonas caused mostly mild infections but also moderate and severe infections. Aeromonas caused milder infections in patients without IBD.