60例星座链球菌感染者的临床特点及其分离菌株的耐药性分析

Clinical characteristics and drug resistance analysis of 60 cases of Streptococcus Constellatus infection,and analysis of drug resistance of isolated strains

目的探讨星座链球菌感染的临床特点及对常用抗菌药物的耐药情况,为星座链球菌感染的诊断和治疗提供依据与方向。方法收集2019年3月至2022年2月福建医科大学附属龙岩第一医院收治的60例星座链球菌感染者的临床资料,包括一般资料、临床表现、感染部位、辅助检查、治疗及转归、菌株分布、混合感染及药敏结果,回顾性分析患者的临床特点和分离菌株耐药情况。结果男性和36~55岁患者是星座链球菌感染的主要群体,冬季发病率低;感染部位多见于腹腔和胸部,最常见受累器官为阑尾,以发热、腹痛、咳嗽咳痰等为主要临床表现。大部分患者的白细胞数(WBC)、中性粒细胞绝对值(NEUT)、C反应蛋白(CRP)及降钙素原(PCT)水平升高,血白蛋白(Alb)降低。16.7%病例合并有其他病原菌感染,与大肠埃希菌的共同感染最为常见。混合感染多见于腹内感染,患者住院时间较长;老年组(≥65岁)住院时间(t=3.418,P=0.001)和联合用药(χ^(2)=3.972,P=0.046)要高于其他组别。星座链球菌对青霉素类、头孢菌素类等多种抗生素高度敏感,但对克林霉素、红霉素和四环素的耐药率较高。结论星座链球菌感染多见于伴有基础疾病的成年男性且临床表现复杂多样。临床应重视星座链球菌的培养,依据药敏结果选用抗菌药物,以提高治疗效果。

This study was aimed at exploring the clinical characteristics of Streptococcus constellatus infection and resistance to commonly used antibiotics,to provide a basis and direction for the diagnosis and treatment of Streptococcus constellatus infections.Clinical data were collected for 60 patients with Streptococcus constellatus infections admitted to Longyan First affiliated Hospital of Fujian Medical University between March 2019 and February 2022,including general data,clinical manifestations,infection sites,auxiliary examinations,treatment and prognosis,strain distribution,mixed infection,and drug sensitivity results.The clinical characteristics of these patients and the drug resistance of isolated strains were retrospectively analyzed.Most Streptococcus constellatus infections were found in men and in patients 36-55 years old.The incidence was low in winter.The most common infection site was the abdominal cavity,followed by the chest.The most commonly affected organ was the appendix.Fever,abdominal pain,cough,and expectoration were the main clinical manifestations.In most patients,the white blood cell count(WBC),absolute neutrophil count(NEUT),C-reactive protein(CRP),and procalcitonin(PCT)were elevated,and serum albumin(Alb)was diminished.A total of 16.7%of cases were mixed infections,and Escherichia coli was the most common co-infection.Mixed infection was most common in intra-abdominal infection,and was associated with longer hospitalization time(t=3.418,P=0.001),combined medication(χ^(2)=3.972,P=0.046)and age≥65 years.Streptococcus constellatus was highly sensitive to a variety of antibiotics,such as penicillin and cephalosporin,but had a high rate of resistance to clindamycin,erythromycin,and tetracycline.Streptococcus constellatus infection was most common in men with underlying diseases,and its clinical manifestations were complex and diverse.To improve treatment effects,greater attention should be paid to the cultivation of Streptococcus constellatus,and antibiotics should be selected according to drug sensitivity results.