儿童葡萄球菌性烫伤样皮肤综合征临床及实验室特点分析

Clinical and laboratory characteristics of staphylococcal scalded skin syndrome in children

目的:分析葡萄球菌性烫伤样皮肤综合征(staphylococcal scalded skin syndrome, SSSS)患儿的临床及实验室特点。方法:分析2014年5月-2017年5月共49例SSSS患儿的临床特点,并以其为观察组,同期选取60例健康体检儿童为健康对照组,比较两组儿童T细胞亚群及免疫球蛋白结果。对患儿脓疱液或脓性分泌物进行细菌培养,将分离到的金黄色葡萄球菌进行药敏分析。结果:42例SSSS患儿皮损初发于面部。观察组患儿T细胞亚群CD3^+、CD4^+、免疫球蛋白IgG水平明显低于健康对照组,差异有统计学意义(P<0.05)。共分离得到28株细菌,以金黄色葡萄球菌为主,占71.43%(20/28)。结论:SSSS主要引起5岁以下婴幼儿感染,患儿T淋巴细胞亚群及免疫球蛋白指标的检测为了解患儿的免疫功能状态、免疫调节及支持治疗提供了理论依据。同时,病原学依据对该疾病的精准治疗、预后评估具有重要意义。

Objective: To analyze the clinical and laboratory characteristics of staphylococcal scalded skin syndrome(SSSS) in children. Methods: A total of 49 children with SSSS and 60 healthy children were enrolled from May 2014 to May 2017. T cell subsets and immunoglobulin levels were compared between the two groups. Antibiotic susceptibility test of Staphylococcus aureus from purulent secretions was also performed. Results: The early stage of SSSS was characterized by facial rashes. Serum CD3^+ and CD4^+T cells, and immunoglobulin G levels were significantly lower in patients than in the healthy controls(P<0.05).Among the 28 strains of pathogens isolated, Staphylococcus aureus accounted for 71.43%(20/28). Two strains were methicillin-resistant Staphylococcus aureus(MRSA). Conclusions: Children under 5 years old are at a greater risk of infections.Changes in T lymphocyte subsets and immunoglobulin levels in children with SSSS can serve as an indicator of immune function, providing rationale for supportive therapy. Determination of etiology is important for precision treatment and evaluation of prognosis.