对比分析革兰阳性球菌及肠杆菌科细菌所致小儿肺部感染的临床特征

Clinical characteristics of pediatric pulmonary infection caused by gram-positive cocci and Enterobacteriaceae

目的对比分析革兰阳性球菌及肠杆菌科细菌所致小儿肺部感染的临床特征。方法以回顾性分析的方式选择平顶山市中医医院2020年1月至2022年12月就诊的100例肺部感染患儿临床资料,根据痰标本微生物培养结果将其分为革兰阳性球菌组(n=45)、肠杆菌科细菌组(n=55),统计不同的病原菌类型,比较两组一般资料、合并基础性疾病、格拉斯哥昏迷指数评分、最高体温以及血常规指标,进行Logistic分析。结果100例研究对象中,肺炎链球菌15例,金黄色葡萄球菌14例,表皮葡萄球菌10例,肠球菌6例,大肠杆菌20例,克雷伯氏菌17例,枸橼酸杆菌9例,阴沟肠杆菌7例,鲍曼不动杆菌2例。两组年龄、性别、合并基础疾病类型、昏迷时间比较差异无统计学意义(P>0.05);革兰阳性球菌组的格拉斯哥昏迷指数评分、淋巴细胞百分比低于肠杆菌科细菌组,最高体温、白细胞计数、中性粒细胞绝对值、中性粒细胞百分比高于肠杆菌科细菌组(P<0.05)。Logistic分析显示,格拉斯哥昏迷指数评分、血常规指标均属于独立危险因素(P<0.05)。结论革兰阳性球菌、肠杆菌科细菌两种不同致病菌感染的肺部感染患儿,其临床特征存在一定差异性,主要表现在血常规指标上的差异,在不确定病原学的情况下,为患儿的安全用药提供有利条件。

【Objective】To analyze the clinical characteristics of pediatric pulmonary infection caused by gram-positive cocci and Enterobacteriaceae.【Methods】The clinical data of 100 patients with pediatric pulmonary infection during January 2020 to December 2022 were selected and divided into gram-positive cocci group(n=45)and Enterobacteriaceae group(n=55)according to the results of sputum specimens.The two groups of general data,underlying disease,Glasgow coma index score,the highest body temperature and blood routine index were compared and performed logistic analysis.【Results】Among the 100 cases,there were 15 cases of Streptococcus pneumoniae,14 cases of Staphylococcus aureus,10 cases of Staphylococcus epidermidis,6 cases of Enterococci,20 cases of E.coli,17 cases of Klebsiella,9 cases of Citrobacter,7 cases of Enterobacter cloacae and 2 cases of Acinetobacter baumannii.There was no significant difference in age,sex,combined underlying disease type and coma time between the two groups(P>0.05).Glasgow coma index score and lymphocyte percentage of gram-positive cocci group were lower than those of Enterobacteriaceae group,while the highest body temperature,white blood cell count,absolute neutrophil count,and neutrophil percentage were higher than those of Enterobacteriaceae group(P<0.05).Logistic analysis showed that Glasgow coma index score and blood routine indicators were independent risk factors(P<0.05).【Conclusion】The clinical characteristics of children with gram-positive cocci and Enterobacteriaceae are mainly manifested in the differences in blood routine indicators,which can provide favorable conditions for the safe drug use of children in the case of uncertain etiology.