侵袭性肺炎链球菌病临床特征与血清型分布  

Clinical characteristics of invasive pneumococcal disease and its serotype distribution

作　　者：周凯[1] 谢国锦[2] 王晓卫[2] 徐飞[2] 姚开虎[3] 

机构地区：[1]南京医科大学附属南京儿童医院内科,江苏南京210008 [2]南京医科大学附属南京儿童医院检验科,江苏南京210008 [3]北京儿童医院北京市儿科研究所微生物研究室国家呼吸系统疾病临床医学研究中心,北京100045

出　　处：《中华医院感染学杂志》2015年第15期3392-3394,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81371853)

摘　　要：目的分析侵袭性肺炎链球菌病(IPD)临床特征及血清学分布资料,为IPD诊断与治疗提供参考依据。方法回顾性分析2009年1月-2013年12月收治的43例IPD患儿临床资料及分离出51株肺炎链球菌(SPN)血清型分布,采用SPSS17.0软件进行统计分析。结果临床特征显示,IPD患儿以两岁以下居首位占58.14%;67.44%患儿冬春季发病,83.72%患儿为社区获得性感染;疾病谱主要是败血症占48.84%、化脓性脑膜炎占18.61%、化脓性胸膜炎占16.28%;5例占11.63%有基础疾病,以先天性心脏病最多见;临床治愈28例、好转11例、3例未愈自动出院,死亡1例;5例并发症分别是脓毒性休克2例,急性呼吸窘迫综合征、硬膜下积液及癫痫各1例;51株SPN常见血清型是19F、19A、14和9V,分别占27.45%、19.61%、17.65%和9.81%,有1株无法确定血清型。结论 IPD好发于2岁以下患儿,疾病谱以败血症最多见,血清型主要是19F、19A、14和9V,推荐接种13价肺炎链球菌结合疫苗。OBJECTIVE To investigate the clinical characteristics of invasive pneumococcal disease （IPD）and its se‐rotype distribution ,so as to improve the diagnosis and treatment of this disease .METHODS Clinical characteris‐tics of 43 children with IPD from Jan .2009 to Dec .2013 and 51 strains of invasive Streptococcus pneumoniae were analyzed retrospectively .The software SPSS17 .0 was used for statistical analysis .RESULTS The clinical charac‐teristics showed IPD children younger than 2 years accounted for the highest proportion （58 .14% ） . Most （67 .44% ）episodes occurred in winter and spring .The main origin of infection was community （83 .72% ） .The main disease spectra were septicemia （48 .84% ） ,pneumococcal meningitis （18 .61% ） ,and purulent pleurisy （16 .28% ） .Among the IPD children ,5 cases（11 .63% ）had underlying diseases ,mainly including congenital heart disease .Totally 28 patients were cured ,11 improved ,3 not improved and 1 died .The complications included sep‐tic shock（2 cases） ,acute respiratory distress syndrome （1 case） ,infective subdural effusion（1 case）and seizure（1 case） .The most common serotypes of 51 S .pneumoniae were 19F（27 .45% ） ,19A（19 .61% ） ,14（17 .65% ）and 9V（9 .81% ） .CONCLUSION Children aged less than 2 years are prone to IPD ,and septicemia is often seen in this disease .The most common serotypes of 51 S .pneumoniae are 19F ,19A ,14 and 9V .The 13‐valent pneumococcal conjugate vaccine（PCV13）is recommended for this disease .

关 键 词：侵袭性肺炎链球菌病 血清型 分布 患儿 

分 类 号：R378[医药卫生—病原生物学]