慢性肝病患者合并解没食子酸链球菌血流感染的临床特征分析  

Clinical characteristics of bloodstream infection of streptococcus gallolyticus in patients with chronic liver disease

作　　者：陈铭[1] 丁秀荣[1] 于艳华[1] 康艳芳[1] 王晨[1] 娄金丽[1] Chen Ming;Ding Xiurong;Yu Yanhua;Kang Yanfang;Wang Chen;Lou Jinli(Departments of Clinical Laboratory,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院临床检验中心,100069

出　　处：《北京医学》2021年第7期628-631,共4页Beijing Medical Journal

摘　　要：目的总结慢性肝病患者解没食子酸链球菌(Streptococcus gallolyticus,S.gallolyticus)血流感染的临床及病原学特点。方法选取2015年1月至2020年10月首都医科大学附属北京佑安医院收治的慢性肝病合并S.gallolyticus感染者26例,记录并分析其临床和实验室检查资料。结果26例S.gallolyticus感染者中医院感染12例(46.2%),社区获得性感染14例(53.8%)。主要临床表现为发热、肝性脑病、上消化道出血、腹痛腹泻等。S.gallolyticus血培养的平均报阳时间(11.4±3.9)h。该菌对β-内酰胺类、碳青霉烯类和糖肽类抗菌药物的敏感率高,而对红霉素、克林霉素、左氧氟沙星的敏感率分别为7.7%、7.7%和34.6%,对四环素不敏感。结论慢性肝病患者合并S.gallolyticus血流感染的临床表现缺乏特异性,该菌对红霉素、克林霉素、左氧氟沙星和四环素耐药率高,临床应根据药敏结果合理选择抗菌药物,以及时控制感染并减少耐药的发生。Objective To summarize the clinical and pathogenic characteristics in Streptococcus gallolyticus bloodstream infection of patients with chronic liver disease.Methods The clinical information,microbial sensitivity and outcome in 26 cases of Streptococcus gallolyticus bloodstream infection of patients with chronic liver disease from January 2015 to October2020 were conducted through a retrospective survey.Results Among 26 cases of Streptococcus gallolyticus bloodstream infection,12 cases(46.2%)were nosocomial infection and 14 cases(53.8%)were community-acquired infection.The main clinical manifestations were fever,followed by hepatic encephalopathy,upper gastrointestinal bleeding,abdominal distension and pain,and so on.Most Streptococcus gallolyticus isolates were sensitive toβ-lactam,carbapenems and glycopeptide antibiotics and resistance to erythromycin,clindamycin,levofloxacin and tetracycline.Conclusions The clinical manifestations of Streptococcus gallolyticus bloodstream infection in patients with chronic liver disease are lack of specificity.Streptococcus gallolyticus showed high drug resistance to erythromycin,clindamycin,levofloxacin and tetracycline.Rational use of antibiotics based on the results of drug sensitivity is important to timely control of bloodstream infection and reduce the occurrence of drug resistance.

关 键 词：解没食子酸链球菌 血流感染 慢性肝病 

分 类 号：R575[医药卫生—消化系统] R515[医药卫生—内科学]