婴儿肉毒杆菌中毒的临床研究进展

Progress in clinical research on infantile botulism

婴儿肉毒杆菌中毒(infant botulism, IB)于1976年在美国首次被发现,常发生在12月以下婴儿中。迄今为止,在有人居住的大陆几乎都报告了IB病例。IB是肉毒杆菌孢子产生神经毒素(BONT)所导致的进行性运动神经麻痹性疾病。由于婴儿肠道菌群还未完全建立,肠道功能还未发育成熟,孢子更容易在肠道定植导致,使婴儿出现以便秘、吞咽困难、烦躁、自主神经功能障碍、肌无力和弛缓性麻痹等为主的症候群,严重影响了婴儿健康,甚至死亡。因此本文就IB的病因、发病机制、流行病学、临床表现、诊断依据和治疗进行总结归纳,以期为防治该病提供参考。

Infant botulism(IB) was first identified in the United States in 1976 and often occurs in infants younger than 12 months of age. To date, cases of IB have been reported in almost all of the inhabited continents. IB is a progressive motor nerve palsy disease caused by the production of neurotoxin(BONT) by the spores of Clostridium botulinum. Because the infant intestinal flora has not yet been fully established, the intestinal function has not yet developed and matured, the spores are more likely to colonize in the intestinal tract, resulting in constipation, dysphagia, irritability, autonomic nervous dysfunction, muscle weakness and flaccid paralysis syndrome, which seriously affect the health of the infants, and even cause death. Therefore, this paper summarized the etiology, pathogenesis, epidemiology, clinical manifestations, diagnostic basis and treatment of IB to provide reference for the prevention and treatment of the disease.