百日咳患儿混合感染病原学特点及药物治疗策略分析  

Etiological characteristics and drug treatment strategies of mixed infection in children with pertussis

作　　者：赵玉婷[1] ZHAO Yu-ting(Tai'an Maternal and Child Health Hospital,Tai'an 271000,China)

机构地区：[1]泰安市妇幼保健院,271000

出　　处：《中国实用医药》2023年第7期93-96,共4页China Practical Medicine

摘　　要：目的分析百日咳杆菌(Bp)合并其他病原体感染患儿的临床特征和耐药现状,为药物治疗选择提供参考。方法回顾性分析85例诊断为百日咳杆菌合并其他病原体感染患儿及65例单纯百日咳杆菌感染患儿的临床资料。分析患儿的感染及耐药情况,住院指标。结果2018年1~12月收治合并多种病原体感染的百日咳患儿共85例,合并肺炎支原体感染20例(23.53%),合并病毒感染30例(35.29%),合并细菌感染29例(34.12%),合并真菌感染6例(7.06%)。发病年龄<1岁54例,其中合并肺炎支原体感染10例,病毒感染14例,细菌(包括真菌)感染30例;1~3岁19例,其中合并肺炎支原体感染4例,病毒感染10例,细菌(包括真菌)感染5例;>3岁12例,其中合并肺炎支原体感染6例,病毒感染6例。单纯百日咳组、百日咳合并细菌(真菌)感染组、百日咳合并病毒感染组、百日咳合并肺炎支原体感染组的住院天数、治疗费用、药品费用、抗菌药物费用比较,差异具有统计学意义(Z=24.774、42.771、20.300、11.554,P<0.05)。百日咳合并细菌(真菌)感染组的住院天数长于单纯百日咳组,治疗费用、药品费用、抗菌药物费用均高于单纯百日咳组,差异具有统计学意义(Z=-4.696、-5.756、-4.159、-3.140,P<0.05)。结论百日咳患儿合并其他病原体感染多发生于<1岁婴儿,合并病原体感染以病毒、细菌和肺炎支原体为主,细菌感染中以流感嗜血杆菌、肺炎链球菌、金黄色葡萄球菌感染为主。根据药敏试验结果,合并其他细菌感染的百日咳患儿治疗方案以红霉素为基础治疗,可联合使用青霉素类复合制剂。与单纯百日咳患儿相比,合并细菌感染的百日咳患儿其住院天数、治疗费用、药品费用及抗菌药物费用均明显增加。Objective To analyze the clinical characteristics and drug resistance of children with Bordetella pertussis(Bp)infection combined with other pathogens,so as to provide reference for drug treatment.Methods The clinical data of 85 children with Bordetella pertussis combined with other pathogens and 65 children with pure Bordetella pertussis infection were analyzed retrospectively.The infection,drug resistance and hospitalization indexes were analyzed.Results From January to December 2018,a total of 85 children with pertussis complicated with multiple pathogenic infections were admitted,including 20 cases(23.53%)complicated with mycoplasma pneumoniae infection,30 cases(35.29%)complicated with viral infection,29 cases(34.12%)complicated with bacterial infection,and 6 cases(7.06%)complicated with fungal infection.The age of onset was<1 year old in 54 cases,including 10 cases with Mycoplasma pneumoniae infection,14 cases with viral infection and 30 cases with bacterial(including fungal)infection;the age of onset was 1-3 years old in 19 cases,including 4 cases of Mycoplasma pneumoniae infection,10 cases of viral infection,and 5 cases of bacterial(including fungal)infection;the age of onset was>3 years old in 12 cases,including 6 cases of Mycoplasma pneumoniae infection and 6 cases of viral infection.The differences were statistically significant when comparing the number of hospital days,treatment costs,drug expense,and antimicrobial drug costs in the pertussis group,pertussis combined with bacterial(fungal)infection group,pertussis combined with viral infection group,and pertussis combined with Mycoplasma pneumoniae infection group(Z=24.774,42.771,20.300,11.554;P<0.05).The number of hospital days in pertussis combined with bacterial(fungal)infection group was longer than that in pertussis group;the treatment costs,drug expense,and antimicrobial drug costs in pertussis combined with bacterial(fungal)infection group were higher than those of pertussis group,and the differences were statistically significant(Z=24.774,42.7

关 键 词：儿童 百日咳 合并病原菌感染 耐药率 药物治疗 

分 类 号：R725.1[医药卫生—儿科]