侵袭性流感嗜血杆菌感染患儿的临床特征及预后分析  

Analysis of clinical characteristics and prognosis of children with invasive Haemophilus influenzae infection

作　　者：王雪宁 朱巧棉 WANG Xuening;ZHU Qiaomian(Special Needs Department,Xi'an Children's Hospital,Xi'an 710000,China;Neonatal Intensive Care Unit,Xi'an Children's Hospital,Xi'an 710000,China)

机构地区：[1]西安市儿童医院特需科,陕西西安710000 [2]西安市儿童医院新生儿重症监护室,陕西西安710000

出　　处：《临床医学研究与实践》2023年第19期44-47,共4页Clinical Research and Practice

摘　　要：目的探讨侵袭性流感嗜血杆菌(HI)感染患儿的临床特征及预后情况,为临床诊治工作提供参考依据。方法回顾性纳入2012年1月至2020年9月我院收治的168例侵袭性HI感染患儿。分析患儿的一般资料、症状、体征、实验室血清学指标;分析实验室HI培养结果、侵袭性HI菌株药敏结果、抗菌药物治疗情况;分析患儿预后转归情况,并根据是否合并化脓性脑膜炎和合并化脓性脑膜炎HI培养结果将其进行分组,比较各组的临床资料。结果168例患儿中,男100例,女68例,中位年龄1.50(1.00,8.00)岁;合并基础疾病40例,存在发热症状164例,存在明确感染灶150例。168例患儿中,脑脊液和血液培养阳性分别为42、146例。接受药敏试验164株,菌株内检测到β内酰胺酶44株,氨苄西林耐药74株。入院后接受1、2、3种及以上抗菌药物治疗分别为74、46、48例。168例患儿中,治愈好转出院140例,死亡或自行出院后死亡22例,自行出院后失访6例。合并化脓性脑膜炎组的入院前感染时间短于未合并化脓性脑膜炎组,入院时C-反应蛋白(CRP)、峰值CRP、降钙素原(PCT)水平高于未合并化脓性脑膜炎组,治愈好转率低于未合并化脓性脑膜炎组(P<0.05)。合并化脓性脑膜炎HI培养阳性亚组的白细胞(WBC)计数高于HI培养阴性亚组(P<0.05)。结论小儿侵袭性HI感染多见于合并基础疾病人群,其中合并化脓性脑膜炎患儿预后较差。Objective To explore the clinical characteristics and prognosis of children with invasive Haemophilus influenzae(HI)infection,and to provide references for clinical diagnosis and treatment.Methods A total of 168 children with invasive HI infection admitted in our hospital from January 2012 to September 2020 were retrospectively included.The general data,symptoms,signs and laboratory serological indicators of the children were analyzed;the laboratory HI culture results,the drug susceptibility results of invasive HI strains and the treatment of antibiotics were analyzed;the prognostic outcome of children was analyzed,the children were grouped according to whether combined with purulent meningitis and combined with purulent meningitis HI culture results,and the clinical data of each group were compared.Results Among the 168 children,there were 100 boys and 68 girls,with a median age of 1.50(1.00,8.00)years;there were 40 cases with underlying diseases,164 cases with fever symptoms,and 150 cases with definite infection.Among the 168 children,42 and 146 cases were positive for cerebrospinal fluid and blood culture,respectively.164 strains were tested for drug sensitivity,44 strains ofβ-lactamase and 74 strains of ampicillin resistance were detected.After admission,74,46 and 48 children received 1,2,and 3 or more antibiotics,respectively.Among the 168 children,140 were cured and discharged,22 died or died after discharge,and 6 were lost to follow-up after discharge.The time of infection before admission in the purulent meningitis group was shorter than that in the without purulent meningitis group,the levels of admission C-reactive protein(CRP),peak CRP and procalcitonin(PCT)were higher than those in the without purulent meningitis group,and the rate of cure and improvement was lower than that of the without purulent meningitis group(P<0.05).The white blood cell(WBC)count in the HI culture positive subgroup with purulent meningitis was higher than that in the HI culture negative subgroup(P<0.05).Conclusion Invasive HI

关 键 词：小儿 侵袭性流感嗜血杆菌 临床特征 预后 

分 类 号：R725.6[医药卫生—儿科]